Vol. 17, No. 3 • N EWS FOR H EALTH & H EALING ® • Fall 2016
chronic disease Anti-Inflammatory Inside Side Effects Carry news High Price Tag Labeling Advocates Vow to Fight GMO By Rachael Adams “DARK” Act Contributing Writer p. 4
Anti-in ammatory drugs hold the top spot for specialty drug spending, accounting for 23% of all dollars spent on specialty medications. Unfortunately, these drugs are among the most common culprits when it comes to adverse e ects, which cost us billions—$2.2 billion from 2010 to 2014, to be exact. Those data come from a joint report entitled The Cost and Impact of Adverse Events: Anti- nutrition & In ammatory Drugs, published by Advera Health lifestyle Analytics and Atlantic Information Services. Goji Berries May Prevent Advera, a California-based healthcare infor- Diabetic Retinopathy matics company that analyzes drug side- People often believe they make political decisions based on their views about issues and e ects data to improve patient safety, and p. 9 policies. According to cognitive scientist, George Lakoff, our voting decisions are shaped Atlantic, a DC-based hospital industry pub- more by unconscious cognitive frames, metaphors and narratives than rational arguments. lisher, teamed up to compile and analyze These are neurologically complex and deeply rooted in survival instincts. mountains of post-market data from the FDA’s Photo by Kara McCurdy Adverse Event Reporting System to calculate the adverse event burden of seven of the most psyche & soma commonly prescribed anti-inflammatories: Cimiza, Enbrel, Humira, Otezla, Remicade, Sim- poni, and Stelara. Strong Fathers, Glass Ceilings & The ndings are troubling. holistech Side e ects from these drugs cost the The Neurobiology of Political Elections healthcare system roughly $368 million per Mushroom-Derived year, adding an average of 2.4% to the cost of “What cognitive science and neuroscience Compound O ers Promise By Erik Goldman covering these drugs. The nancial statistics, have shown us over the last 30 years is that though alarming, do not capture the dimen- in Chronic Fatigue Editor in Chief every part of this is false. Every single part,” sion of additional human su ering experi- p. 12 Lako told Holistic Primary Care in an inter- enced by people who seek relief from chronic view. The science indicates that human rea- in ammatory diseases, but nd that their “A human brain is a remarkable thing. It isn’t son is: what you think it is, and every part of it mat- problems are only complicated by adverse ters in politics. If you are going to be a good • Largely unconscious—most of the time drug e ects. citizen—conservative or liberal—you should we are unaware of it see Side E ects p. 10 know how your brain is working.” • Not abstract, but determined by the body Cognitive scientist George Lakoff has and its needs spent four decades studying how the human • Highly emotional, even when it seems environomics mind makes meaning, and how that factors dispassionate into politics. He concludes that while people • Shaped more by images, metaphors, and may believe they are “voting their conscience,” culturally-determined frames than mea- for the most part they are voting their surable facts New Urine Test Detects Roundup Residue “un-conscience.” • Driven as much—perhaps more—by may also be a candidate for the glyphosate Lako , a professor of linguistics at UC– social pressure as rational self-interest. By Kristen Schepker test, as would patients with signs of metal Berkeley, says 98% of what we call our reason- Lako is among a group of linguists, soci- Assistant Editor toxicity. ing is going on unconsciously. “It is what our ologists, and cognitive scientists including brain is doing while we’re busy thinking we Noam Chomsky, Erving Go man, and Charles King of Herbicides are being conscious.” Fillmore, who have looked critically at the In response to the upsurge in concern about First marketed as a commercial product in the Through his academic work as well as ways language shapes perception, behavior, the detrimental health e ects of glyphosate, mid-1970s, glyphosate now has the dubious popular books like The Political Mind (2008), and political choice. Kansas-based Great Plains Laboratory (GPL) honor of being the most widely sprayed syn- Don’t Think of an Elephant (2004), and Meta- Though he personally leans leftward and has introduced a new urine test that allows thetic herbicide in agricultural history. For phors We Live By (2003—with Mark Johnson), aligns strongly with the Democrats, Lako practitioners to make more accurate assess- years, prevailing scienti c consensus was that Lako stresses that we cannot understand stresses that people across the political spec- ments of patients’ exposure to this widely the weed killer was harmless to humans—but modern politics using an 18th century view of trum benefit from understanding what used herbicide. increasing reports of toxicity associated with human reason. shapes their decisions. The glyphosate test can provide useful glyphosate exposure suggest otherwise. This classical view, which prevails in many information in the workup of any patients suf- Intensive and extensive use of this herbicide public policy circles, was initially de ned by Skyrockets, Glass Ceilings, fering from severe illness of unknown origin, has been linked to an alarming assortment of Descartes in the 1600’s. It holds that reason is: Warm Welcomes notes GPL’s lab director, William Shaw, PhD. modern diseases. The test’s target groups include individu- • Conscious—that we know when we’re The neurological truth, says Lako , is that we A broad-spectrum herbicide sold under vari- als who develop chronic diseases either more ous trademarks, glyphosate is a generic com- doing it do not see the world as it is. We see it through rapidly or at an earlier age than typically • Disembodied and abstract cognitive frames that emphasize, de-empha- pound best known as the active ingredient in expected. One example might be a 30-year- Monsanto’s Roundup® formulation. It is found in • Dispassionate; Universal size, amplify or mute the input from our senses. old with Parkinson’s disease, which generally • Able to assess the world as it is “When you perceive something—some- more than 700 di erent agricultural, forestry, occurs much later in life. Dr. Shaw notes that and home gardening products. Worldwide, • Purposeful in the service of rational thing comes into your eyes—you have about “anyone with a severe chronic illness who is self-interest. see Neurobiology of Politics p. 13 not getting better using traditional methods” see Urine Test p. 2 2 environomics Fall 2016
do “contain an ingredient that is toxic to some fish.” So The IARC cited several studies indicating Urine Test the official position is that glyphosate is one of the glyphosate’s carcinogenicity in humans and experi- least noxious herbicides available. mental animals. cont’d from page 1 But a review of the scientific literature reveals Among the IARC-cited research was a meta- numerous environmental threats stemming from analysis of epidemiologic studies indicating a glyphosate usage has grown almost 15-fold in the last intensive glyphosate application. For example, strong positive association between non-Hodgkin two decades alone, following the biotech behemoth’s heavy use can contribute to the development of lymphoma (NHL) and occupational exposure to introduction of “Roundup Ready” (RR) genetically resistant crop varieties. Annett et al. argue that reli- glyphosate in agricultural settings. “Striking modified (GM) glyphosate-tolerant crops. ance on glyphosate as a primary weed control increases in the incidence of [NHL] cancer have Engineered to withstand glyphosate, RR plants method promotes weed resistance, which in turn occurred in the last 30 years,” its authors write, “and can be treated with the herbicide without harm, prompts growers to apply increasing amounts of interest in identifying environmental and occupa- while any nearby weeds or other plants are herbicide from year to year (Annett R, et al. J App tional exposures associated with this cancer has destroyed. In 1996, RR soybean, corn, and cotton Toxicol. 2014; 34(5): 458–479). accompanied this trend” (Schinasi L, Leon M. Int J varieties were approved for planting in the US; today, Others have shown that glyphosate can dis- Environ Res Public Health. 2014; 11(4): 4449–4527). Monsanto’s lineup of GM Roundup-resistant crops rupt soil microbial communities, making plants Stories from around the globe tell similarly also includes alfalfa, canola, sorghum, sugarbeets, more vulnerable to pathogens and reducing the troubling tales. In Argentina, the world’s third larg- and wheat (Benbrook C. Environ Sci Eur. 2016; 28: 3). availability of certain soil minerals and micronutri- est producer of GM crops—the majority of which Glyphosate’s herbicidal properties derive from ents (Benbrook C. Environ Sci Eur. 2012; 24: 24. are RR soybeans—glyphosate exposure among its ability to interrupt a metabolic route known as Additionally, in environments where geneti- pregnant women was linked to an increased risk of the shikimate pathway. While the shikimate path- cally modified herbicide-resistant crops dominate, birth defects (de Araujo J, et al. BMC Public Health. way is present in plants as well as bacteria, fungi, biodiversity dwindles, reducing the number of 2016; 16: 472). and algae, it doesn’t exist in animals. In plants insect and bird species. In one case, researchers Researchers also point to glyphosate as a cul- exposed to the herbicide, this pathway—essential linked increased glyphosate use on corn and soy- prit behind a recent rise in chronic kidney disease for the synthesis of the essential aromatic amino bean crops to a large decline in milkweed in the in regions of South Asia (Abraham G. Clin Kidney J. acids, phenylalanine, tyrosine, and tryptophan— Midwest. This, they argued, resulted in a significant 2016; 9(1): 135–141). becomes disrupted, ultimately killing the plants. decrease in the local monarch butterfly population Findings like these raise important questions The absence of the shikimate pathway in human (Pleasants J, Oberhauser K. Insect Cons & Divers. about the previously overlooked human health cells formed the basis of assumptions that glypho- 2013; 6(2): 135–144). risks. Does this herbicide present the same haz- sate isn’t dangerous to us or to other mammals. ards to those who don’t live or work in heavy agri- Concurrent with glyphosate’s soaring popular- Pretty Safe . . . For a Carcinogen cultural areas? If so, what are the risk factors for ity in both agricultural and backyard gardening Butterfly die-offs may be tragic, but they hardly exposure? settings, many regulatory bodies have weighed in constitute a public health crisis. If the authorities Many speculate that the consumption of on the herbicide’s safety. Unsurprisingly, Monsanto have deemed glyphosate safe for human exposure, glyphosate-contaminated foods is a key cause of claims that “authorities worldwide have concluded why are so many people concerned? poor health not only among farm workers, but that glyphosate, when used according to label Over the last decade, a number of scientists have within the population as a whole. It’s known that directions, does not pose an unreasonable risk to begun to question the long-term impacts of glypho- glyphosate residues are present in many staple human health, the environment, or non-target ani- sate not just on environmental health, but on human foods—principally sugar, corn, soy, and wheat. mals and plants.” health as well. In March of last year, the World Health According to the early results of a unique pub- According to the US Environmental Protection Organization’s International Agency for Research on lic testing project at the University of California Agency, glyphosate has low toxicity for humans, is “no Cancer (IARC) sent shockwaves through the scientific San Francisco (UCSF), contamination rates are sur- more than slightly toxic” to birds, and is “practically community with its assessment of five organophos- prisingly high; glyphosate was found in a stagger- nontoxic to fish, aquatic invertebrates, and honey- phate pesticides, including glyphosate, which it classi- ing 93% of urine samples collected from study bees.” Certain glyphosate products, the Agency adds, fied as “probably carcinogenic.” subjects. The UCSF researchers note that tap water, which they also tested, was free of glypho- sate residues, indicating that contamination likely stems from either dietary intake or environmental exposure. The project started in 2015 and is the The Pesticide Action Network provides a largest glyphosate biomonitoring urine study global listing of glyphosate restrictions by coun- conducted in the US to date, with full results try. Many European countries prohibit certain expected later this year. applications of this herbicide; the Netherlands, for Contaminated animal feed is another potential instance, doesn’t allow any non-commercial source of exposure. Throughout the world, live- glyphosate use, and many municipalities in Bel- stock farmers use GM crops to feed their animals. gium are slated to become entirely pesticide-free Glyphosate residues can then transfer to humans by 2017. In Canada, 8 of the country’s 10 provinces who eat the meat or dairy products derived from in some way restrict the use of “non-essential cos- those animals. metic pesticides,” including glyphosate, which The residual exposure, some researchers argue, cannot be used “in public spaces or by the public • News for Health & Healing® • could play a key role in the development of a broad out-of-doors.” range of chronic illnesses including inflammatory www.holisticprimarycare.net bowel disease, obesity, ADHD, autism, depression, Assessing Glyphosate Burden Alzheimer’s disease, Parkinson’s disease, ALS, mul- Great Plains Laboratory’s new test is an impor- tiple sclerosis, infertility, and developmental mal- Editor-in-Chief Publisher Assistant Editor tant first step in enabling clinicians to more accu- Erik L. Goldman Meg Sinclair Kristen Schepker formations (Samsel A, Seneff S.Entropy. 2013; 15(4): rately assess the burden of glyphosate exposure. 1416–1463). There are also correlations between [email protected] [email protected] The test is simple, requiring just 10 mL of first high glyphosate exposure and cancers of the thy- morning urine, preferably before the patient roid, liver, bladder pancreas and kidney. takes any food or drink. The lab does require that Contributing Writers Design patients taking the test refrain from eating or Rachel Adams Sara Lovelady Madiha Saeed, MD Dorri Olds Microbiome Disruption drinking any soy or soy-based proteins for one Isaac Eliaz, MD Julia Powers New York City One explanation for glyphosate’s ability to wreak week prior to urine collection. www.DorriOlds.com havoc in the human body lies in its potential dis- Most clinicians who have started using the turbance of our intestinal microbiome. Like plants, glyphosate test generally combine it with GPL’s bacteria contain the shikimate pathway—the Toxic Organic Chemical Profile, a test panel that metabolic chain reaction arrested by the herbi- screens for the presence of nearly 200 different Editorial Advisory Board cide—and they are similarly affected by glypho- toxic chemicals. sate exposure. Glyphosate may not be as safe as the initial Robert A. Anderson, MD Lev Linkner, MD scientific consensus would have us believe, and it Founder, Past-President Clinical Faculty, Instructor, and Lecturer Glyphosate may impact our intestinal integ- American Board of Integrative Holistic Medicine rity by decreasing amounts of certain beneficial has certainly come under greater medical scrutiny Dept. of Family Practice in recent years. But GPL’s Dr. Shaw cautions against East Wenatchee, WA University of Michigan, Ann Arbor bacteria, while fostering overgrowth of harmful bacteria. This phenomenon has been observed in over-simplifying the situation. Glyphosate, he Robert Alan Bonakdar, MD Mark Menolascino, MD poultry. Scientists found that some highly patho- says, is only one of many harmful environmental Scripps Center for Integrative Medicine Founder, Meno Clinic elements that may hasten disease development. La Jolla, CA genic bacteria—including strains of Salmonella Centoer for Advanced Medicine and Clostridium—are highly resistant to glypho- “We’ve found a wide range of toxic chemicals David Perlmutter, MD Jackson Hole, WY sate, while other “good” bacteria such as Lactoba- in families with autism,” he stated, “and other Founder/Director Derrick DeSilva, Jr, MD cillus species, Enterococcus faecalis, Enterococcus chemicals are much higher in populations with Perlmutter Health Center faecium, Bacillus badius, and Bifidobacterium ado- autism as compared to normal individuals.” Naples, FL Raritan Bay Medical Center Perth Amboy, NJ lescentis were susceptible to it (Shehata A, et al. Dr. Shaw added that when it comes to GM Steven Masley, MD Curr Microbiol. 2013; 66(4): 350–358). crops, the biggest concern isn’t so much that Director, Masley Optimal Health Center Cathy Rosenbaum, PharmD Imbalances in the intestinal microbiome are they’re genetically modified per se, but that Assistant Clinical Professor Founder/CEO implicated in a vast array of disorders, and some they’re engineered to withstand huge amounts University of South Florida Rx Integrative Solutions of herbicides containing multiple toxic chemicals St. Petersburg, FL scientists point to glyphosate-induced gut dysbio- Cincinnati, OH sis as a possible common cause. In just one exam- all at once. With the global increase in GM herbi- Sanford H. Levy, MD Mark Tager, MD ple, it’s hypothesized that abnormal bacteria can cide-resistant crop planting, larger and larger Physician Advisor, EMR Founder influence the development of autism; researchers portions of the world’s food supply will become Kaleida Health ChangeWell argue that an abundance of Clostridia and/or Desul- simultaneously contaminated—not just with Buffalo, NY San Diego, CA glyphosate, but with all the other compounds Diplomate, American Board of Integrative fovibrio and decreases in Bifidobacteria may be Holistic Medicine involved in autism pathogenesis (Heberling C, et al. contained in those herbicides. Med Hypoth. 2013; 80(3): 264–270). This biochemical reality is far from simple, Additionally, glyphosate is a strong chelating and it can be challenging to determine which The ideas, opinions, commentaries, and viewpoints expressed in the pages of Holistic Primary Care do agent that attracts heavy metals which, when specific compound is “responsible” for which spe- not necessarily reflect those of its Publisher. Ascending Media, L.L.C. will not assume liability for damages, ingested, can cause varying degrees of toxicity, cific adverse health effect. It is equally difficult to injuries, losses, or claims of any kind arising from or related to the information presented in this publica- most commonly affecting the gastrointestinal, make long-term predictions about health risk tion, including claims related to products or services described herein. cardiovascular, hematopoietic, renal, and central based on relatively short-term studies. and peripheral nervous systems. Researchers One thing is clear: widespread glyphosate Holistic Primary Care, News for Health and Holistic Primary Care is published quarterly by point to glyphosate’s metal chelating properties use will likely continue for years to come. We will Healing® is an independent newspaper covering Ascending Media, L.L.C., PO Box 953, Peck Slip Station, as a cause of the current chronic kidney disease need to deepen our understanding of the full holistic, natural, and alternative medicine for a New York, NY 10272-0953, Tel. (212) 406-8957. Copy- epidemic among Sri Lankan rice paddy farmers range of its ecological and human health circulation of approximately 65,000 practicing right © 2016, by Ascending Media, L.L.C. All rights (Jayasumana C, et al. BMC Nephrol. 2015; 16:103). impacts. Until then, existing evidence indicates primary care Medical Doctors, Naturopathic reserved. Material may not be reproduced in whole or Reflecting the growing concerns surrounding that avoidance, guided by careful chemical test- Doctors, Doctors of Osteopathy and in part in any form without written permission. glyphosate’s health risks, several regional and ing, along with eating organic foods, and advo- Chiropractors. Printed in the United States. national bodies now limit—or in some cases, out- cating for small-scale sustainable agriculture, right ban—its use. may be the safest strategy. ProOmega® CRP A Powerful New Solution for Systemic Cellular Stress
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meat, these “Male cent Seven” become the raw materials for the cheap, omnipresent Obama in JAMA: Reform Achieved Two Main Goals junk foods that are literally crippling and kill- increased transparency around drug manu- • 32% say their administrative workload has ing the nation. By Erik Goldman facturing and R&D costs, to grant greater fed- increased since ACA O’Connor cites a study of over 10,000 peo- Editor in Chief eral authority to negotiate drug pricing, and But overall the net impact of reform has ple recently published in JAMA Internal Medi- to revisit the so-called “public option”—a been fairly minimal. Across the ve parame- cine showing that after adjusting for age, sex, Over the summer, Barack Obama became the government backed Medicare-like plan that ters measured—patient volume, time with socioeconomic status, and other obvious rst American president to publish an article would be made available in addition to the patients, administrative burden, practice social variables, those who ate the most foods in a major peer-reviewed medical journal. various for-pro t plans o ered on the federal earnings, and professional satisfaction—well derived from these federally subsidized crops And not just any old medical journal, but the exchanges. over half of all respondents report no change had a 37% increased risk of being obese com- Journal of the American Medical Association. since Reform took e ect. pared with those who ate the least. The July 11 edition of JAMA features a Why JAMA, Why? That could be because 48% of this practi- The farm subsidies programs were started paper entitled “United States Healthcare Having the President publish an analysis of tioner cohort already practices outside the in the 1920s to support small struggling fam- Reform: Progress to Date & Next Steps,” his own legacy legislation is a bit like letting insurance and Medicare/Medicaid systems, or ily farmers. But they’ve long since turned into authored by none other than Barack Obama, a pharma CEO author a study on the compa- because life in medicine was fairly miserable a welfare system for multinational Agribusi- JD. It’s a somewhat historic rst, as no sitting ny’s latest new drug: there’s an awful lot of even before Reform. nesses that grow commodity crops . . . and, President has ever had a study published in a bias to control for, and it’s fair to wonder further downstream, lots of chronic disease. medical journal. whether a paper like this would even pass the Right Answers to Wrong Questions Legislators would do the nation a favor if The article is essentially a progress report rst stage of peer review if its author were not If anybody in Washington—Democrat or they would also take a much more serious on the A ordable Care Act (ACA), based on the POTUS. Republican—were actually serious about look at what holistic and functional medicine analysis of mountains of public data from Mr. Obama is a very smart man, but he’s improving the health of the nation—rather has to o er in the way of ameliorating and 1963 to early 2016. not a doctor (unless we’re counting spin), or than just arguing about the nancing of dis- preventing chronic disease. In it, President Ojama . . . er . . . Obama a public health expert. Why, exactly, did JAMA ease care, they’d do well to take a look at our Mr. Obama made no mention of anything claims that healthcare reform has more or less publish this? nation’s agricultural subsidies programs. related to holistic approaches or functional succeeded in achieving its two main goals: Perhaps it’s the 133-year-old journal’s In an incisive piece called “How the Gov- medicine in his JAMA report, and the more- expanding the number of Americans with attempt to assert cultural relevance in an era ernment Supports Your Junk Food Habit,” New theoretical-than-actual “All Willing Providers” health insurance, and slowing the skyrocket- when the in uence of mainstream medical York Times reporter Anahad O’Connor clause aside, there was little more than a para- ing costs of health care. journals is eroding? revealed that between 1995 and 2010, the graph or two about it in the actual healthcare The study claims that since the ACA JAMA’s Editor in Chief, pediatrician How- government doled out $170 billion in agricul- reform bill. became law, the number of Americans with- ard Bauchner, says the Journal’s board hopes tural subsidies to support production of For all practical purposes, holistic medicine is out insurance dropped by 43%. In 2010, an “that the US presidential candidates will con- seven commodity crops—corn, soy, wheat, not part of the Big Table discussion. But it should estimated 16% of the population was unin- sider submitting to JAMA their ideas about rice, sorghum, milk and meat. be, because whatever happens in November, sured. In 2015, that’s down to just over 9%. further health care reform before the 2016 When re ned into things like corn syrup, the healthcare crisis is not going away, and the And that’s happening even in states that did election. white our, hydrogenated oil, and processed current approaches are not working. not expand their Medicaid programs. JAMA mitigated the bias by including In raw numbers, an estimated 20 million three extensive editorials from public health more Americans got health insurance last experts who challenged many of the Presi- year—the largest expansion of covered lives dent’s assertions. since the creation of Medicare and Medicaid Mr. Butler, a policy analyst at Brookings, Labeling Advocates Vow to Fight 50 years ago. says the A ordable Care Act should be more accurately termed the “Medicaid Expansion The World’s Fifth Largest Economy Act” because the big rise in newly insured GMO “DARK” Act In a season of intense racial strife, civil unrest, people was largely on the Medicaid side. woman Katie Hill, “This measure will provide international instability, and arguably the By Erik Goldman ugliest presidential campaign season since new opportunities for consumers to have Private Plans Still Too Costly Editor in Chief access to information about their food.” the Civil War, it’s not surprising that the Presi- In 2016, new Medicaid enrollees exceeded dent’s medical paper got very little attention. In a statement to Bloomberg News, Hill CBO estimates by 17 million. In contrast, upheld the federal position that GM ingredi- Indeed, in comparison to things like gun vio- enrollment in private sector insurance via the William Sorrell, Attorney General for Ver- lence and terrorist mayhem, healthcare pol- mont—the only state to have implemented ents pose no health threats. “While there is ACA exchanges fell way short of projections broad consensus that foods from genetically icy can barely generate a headline these days. . . . by about 10 million. mandatory GMO labeling—has vowed to But, as the Brookings Institution’s Stuart “take an active role” in ghting a new federal engineered crops are safe, we appreciate the Why? Because for many people, private bipartisan e ort to address consumers’ inter- Butler has astutely pointed out, if US health plans are simply too expensive. GMO labeling law that preempts prior state care were viewed as a separate and distinct rules and that, critics say, obscures rather est in knowing more about their food.” Butler writes that premiums and out-of- Critics say the new law does anything but economy, it would be equivalent to the fth pocket costs put many plans out of reach for than clari es consumer communication. or sixth largest economy in the world. Separately, the Center for Food Safety address consumers’ interests. Despite its lan- middle-class and modest-income house- guage about a “disclosure standard,” the rule Which means that whoever gets elected in holds. They end up choosing “bronze plans” plans to challenge the constitutionality of the November is going to have to deal with it. new federal law, which President Obama permits manufacturers to keep GMO informa- with low premiums and bare bones cata- tion well-hidden behind a tech-barrier. And health care is not something you can strophic coverage. “For many, it is coverage in signed on July 29. build a wall around, or bomb into submission, The bill, S. 764, amends the Agricultural Further, the act does not de ne any penal- name only,” he notes. ties for companies that choose to simply or frack your way out of. Its realities remain Analysts Jonathan Skinner and Marketing Act of 1946, and requires the Sec- stubbornly refractory to rhetoric of whatever retary of Agriculture “to establish a national ignore the QR code mandate. In short, it’s a Amitabh Chandra question whether Obam- toothless and misleading regulation that political stripe. aCare can really lay claim to the observed disclosure standard for bioengineered foods.” The new law skirts the term “GMO” but many labeling advocates call the “DARK” Spending Slows, Care Improves slowdowns in healthcare spending. (“Deny Americans the Right to Know”) Act. They contend that growth in spending de nes “bioengineered” foods as “any food Given its author, one would expect that Mr. started trending downward as early as 2006, that contains genetic material that has been “We Saved Agricultural Biotech” Obama’s paper would present a rosy view of modi ed through in vitro recombinant deoxy- well before both the ACA and the Great Champions of the law, including Sen. Debbie reform, and that it does. He claims ACA has: Recession. The curve-bending numbers ribonucleic acid (DNA) techniques; and for which the modi cation could not otherwise Stabenow (D-Mich) and Senate Agriculture • Improved access to care Obama attributes to Reform are, they say, Chairman Pat Roberts (R-Kan), promoted it as • Reduced amounts of personal medical simply a continuation of earlier downward be obtained through conventional breeding or found in nature.” a reasonable compromise between consum- debt momentum. And that’s a momentum that’s ers who want GMO information, and the food, • Improved health measures about to peter out. However, it excludes many common ingredients—like soy oil—derived from agriculture and biotech industries that do not • Increased system accountability Skinner and Chandra cite data from the believe GMO products carry any risk and that • Improved quality of hospital care Altarum Institute, showing that between genetically modi ed seeds, as well as animal products derived from animals fed on geneti- wish to avoid stigmatization. • Slowed growth in per-enrollee healthcare 2014 and 2016, in ation-adjusted healthcare Both Stabenow and Roberts have received spending spending actually increased—and by 8.1%, cally modi ed crops. Under the new ruling, the US Department campaign funding from agriculture and nearly double the 4.1% growth in gross chemical companies including Dow, DuPont, From 2010 through 2014, mean annual domestic product. of Agriculture has two years to develop and growth in per-enrollee Medicare spending implement a nationwide “labeling” program and Koch Industries. Sen. Roberts is on record Altarum estimates that the share of gross stating that language in the new bill was dropped to −0.6%, compared to a mean domestic product devoted to health care has that would permit interested consumers to growth rate of 2.4% per year from 2006 to nd out if packaged foods contain GM ingre- intended to protect biotech products from also increased, from 17.3% in March 2014 to denigration. “We saved agricultural biotech- 2010. On the private insurance side, spending a record 18.1% in March 2016. The analysts dients by using their smartphones to scan QR growth slowed to 1.1% per year since 2010, (“Quick Response”) codes linked to company nology,” he says. attribute that largely to greater use of health- According to food industry sources, compared with a mean of 3.4% from 2005 to care services. websites. 2010. between 75% and 80% of all commercially If the current trend continues, the Con- Orwellian Double-Speak produced comestibles contain GM ingredi- Reform in the Trenches ents. Nearly all corn- and soy-derived ingredi- gressional Budget O ce estimates that by How is Reform playing out in the trenches of Unlike Vermont’s statewide mandate, and the 2019, Medicare will spend 20% less—that’s labeling laws in other nations, the new law ents are from GM plants. But most consumers clinical practice? do not know that. about $160 billion less—than it did According to Holistic Primary Care’s 2016 does not require makers of foods containing pre-Reform. GMOs to actually state this on food labels. In recent years, GMO labeling advocates in Practitioner Survey of over 850 practitioners, Colorado, Oregon, Maine, Connecticut and Obama claims the reduced spending is the ACA is neither the trainwreck its critics Consumers seeking this information must not adversely a ecting health outcomes, nor rst have access to smartphones and be famil- California tried to follow Vermont’s lead and secretly hoped for, nor the utopia its authors establish their own labeling laws. The initia- is the reform plan the economic wrecking ball dreamed of: iar with using QR codes or “SmartLabels”—a its critics predicted. He writes that “private- situation many critics view as inherently dis- tives passed in Maine and Connecticut, but sector employment has increased in every • 24% of respondents say the number of criminatory against millions of poor people or were not yet implemented. In the other month since ACA became law.” patients seeking care has increased others who do not use smartphones. states, labeling rules were narrowly defeated. But he stressed that the ACA roll-out thus • 7% say time spent with patients has The law is the latest iteration of legislation Industry groups, including the Grocery far is just the start, not a mission accom- decreased that has been bouncing around Congress for Manufacturers Organization, and companies plished. He called on Congress to push for • 12% report declines in practice revenue years. According to White House spokes- see GMO “DARK” Act p. 5 Fall 2016 news 5
sumers the same access to information, in “CFS has no intention of letting this anti- GMO “DARK” Act plain English, that they had under Vermont’s democratic, discriminatory, fake labeling bill cont’d from page 4 law.” stand,” writes Kimbrell. “The idea that con- Sorrell added, “It is unfortunate that cor- sumers would have to call or use their porate interests were ultimately able to water phones on each and every product they buy like Monsanto, DuPont, General Mills, Dow, down Vermont’s clear disclosure standard is absurd. And since more than 100 million PepsiCo, and Coca-Cola strongly opposed through the passage of this federal law.” The Americans, mostly the rural elderly and low these initiatives and spent tens of millions to Vermont AG says he had no plans to mount income, do not even own smartphones, they defeat them. any legal challenge to the federal law. But the will not even have access to the digital label- While it is doubtful that Big Food and Big Center for Food Safety intends to do exactly ing the law promotes. What’s worse, the Ag welcomed a new fed rule, they made it that. law’s narrow definition would exclude many, clear they prefer to operate under one unified and perhaps most, current foods containing system rather than myriad state-level rules A Constitutional Challenge GE ingredients.” that might differ significantly in their defini- Executive Director Andrew Kimbrell said his Given the ubiquity of GM ingredients in tions of GMOs, and their requirements for group “will be filing a federal lawsuit . . . asking our food streams, consumers who want to disclosure. a court to declare the law unconstitutional on avoid them should assume that store-bought a number of grounds and to restore our demo- food items contain GM ingredients unless Squelching State Regs cratically decided upon labeling laws.” In a labeled otherwise. “Labeling GMOs was never the end goal public message to members, Kimbrell called for us. It was a tactic. Labels make it easier The new law specifically states that it super- the new law “a legislative train wreck.” Seek the Butterfly sedes all state regulations: for shoppers to make healthier non-GMO At press time, CFS had not yet outlined the Maggie Westgate, Executive Director of the choices. When enough people avoid GMOs, No State or a political subdivision of a State specifics of its constitutional challenge, but it Non-GMO Project—the nation’s strongest food companies rush to eliminate them. may directly or indirectly establish under any is not likely to be an idle threat: in the past, this and most vigorous voluntary GMO-free label- Labeling can speed up that tipping point— authority or continue in effect as to any food group has won several legal victories against ing program—says the new law only under- but only if consumers are motivated to use or seed in interstate commerce any require- biotech and industrial agriculture, including a scores the need for a meaningful non-GMO labels to avoid GMOs. Therefore, if manda- ment relating to the labeling of whether a 2010 case that put a halt on the planting of standard. It’s something her group is working tory labels had been put into place, we food (including food served in a restaurant or Monsanto’s GM sugar beets in the US. hard to establish. would still be required to educate and moti- similar establishment) or seed is genetically Participation in the project is voluntary, vate consumers.” engineered (which shall include such other and products that carry the group’s Monarch Smith believes the protracted state-level butterfly seal have undergone a battery of battles over labeling have already brought similar terms as determined by the Secretary he idea that consumers of Agriculture) or was developed or produced tests including DNA analysis to ensure they public awareness to that tipping point. using genetic engineering, including any “ would have to call or use do not contain any GM ingredients. While the new regulation may signal that requirement for claims that a food or seed is their phones on each In a recent blog post, Westgate said, “We agribusiness has won a major battle in Con- or contains an ingredient that was developed see this law as the end of meaningful manda- gress, Smith believes the healthy food move- or produced using genetic engineering. product they buy is tory labeling in the United States, a significant ment is winning the war in the grocery aisles. absurd.T What’s worse, the law’s historical development that reinforces the “Major food companies already realize On August 2, just one month after the Ver- critical value of the Non-GMO Project’s mar- that making non-GMO claims gives them a mont mandate took effect, the Attorney Gen- narrow definition would exclude ket-based strategy and reason for existence. competitive edge. Why else would Nestlé’s eral’s office announced that, in compliance many current foods containing As a non-profit, our mission is to preserve and dedicate time during their extremely expen- with the federal law, it would no longer build sources of non-GMO products, educate sive TV commercials to brag that their coffee enforce the statewide mandate. GE ingredients.” shoppers, and provide verified non-GMO creamer is non-GMO? Why else would Dan- But in a statement published on Media- choices.” non announce that their feed for dairy cows Post’s “Marketing Daily” website, AG Sorrell — A ndrew Kimbrell, Jeffrey Smith, director of theInstitute for will be non-GMO within three years? And why stated that he “intends to take an active role Center for Food Safety Responsible Technology, and one of the else would Del Monte, Campbell’s, Hershey’s, as the labeling fight shifts from the legislative nation’s most outspoken critics of GM-based Post, General Mills, Red Gold, Applegate, and process in Congress to the regulatory process agriculture, believes the federal fight over so many others make similar non-GMO com- at the USDA” and to “work hard to give con- GMO labeling is beside the point. mitments? We are totally winning.” 6 environomics Fall 2016 Lead Astray: Enviro Toxins Threaten Community Health Nationwide Assessing Lead Toxicity Inside cells, lead interrupts enzyme activa- Western medical practices primarily for acute By Isaac Eliaz, MD lead exposure rather than chronic accumula- Lead poses a health threat to all. There is no tion and protein synthesis by binding to sulf- Contributing Writer hydryl groups through divalent cations. This tion. This philosophy leaves chronically exposed accepted “safe level” of lead exposure, and it ultimately reduces available sulfhydryl anti- populations without e ective options. is very important for clinicians to keep a keen As integrative practitioners, we have a The toxic drinking water crisis in Flint, Michi- eye out for lead toxicity, especially those who oxidant reserves (Ercal et al. Curr Top Med gan, recently put the danger of lead contami- Chem. 2001; 1: 529–539). unique role to play in addressing the reality practice near communities where water sup- of chronic ongoing low-level exposures. nation in the national spotlight. plies may be compromised. A key biomarker of lead exposure is the As many as 8,000 children in Flint were blockade of the enzyme ALAD (delta-aminolev- The rst and most basic strategy for dealing The clinical signs of acute lead poisoning are with exposure to toxins is to remove the source, exposed to the toxic metal after the city of nonspeci c; therefore a venous blood lead ulinic acid dehydratase). When ALAD is blocked, Flint switched water sources and failed to use its substrate ALA (aminolevulinic acid) builds up, or the exposed individual from the source, to measurement is essential for a de nitive diag- the greatest extent possible. For lead, this may corrosion control protocols designed to pre- nosis. But keep in mind that in response to and causes the reduction of GABA (gamma-ami- vent lead from leaching out of aging pipes. nobutyric acid) in the central nervous system. mean testing drinking water regularly, replac- chronic lead exposure, lead sequestration in the ing pipes, installation of in-home ltration sys- While the situation in Flint was arguably bones can give a misleadingly low blood level. Lead also inhibits the formation of vitamin D, the most dramatic and egregious example of which plays a key role in calcium metabolism. tems, and using bottled water when someone A urine challenge test with an appropriate knows they will be in areas or facilities with con- the end result of careless and negligent envi- chelating agent can provide a more accurate Thus, calcium homeostasis is signi cantly altered ronmental policy, it is by no means the only by lead. This interferes with calcium-dependent taminated water supplies. assessment of body burden. Lead exposure is For other heavy metals and pesticides pro- one. Not by a long shot. most dangerous to children and pregnant signal transduction processes and may alter the In 2016, The New York Times, USA Today, most basic nervous system functions. active solutions include a careful assessment women, since it a ects neurological develop- of dietary contributors such as arsenic in and Time all published investigations reveal- ment. Understandably, much of the coverage In short, lead is highly detrimental to human ing that unsafe levels of lead in drinking physiology, and the rise of lead contamination chicken, rice and rice products, and mercury of the Flint crisis was focused on the massive contamination in sh. water are now commonly observed across impact it has had on the city’s children. But of public water supplies should be a cause for the country, especially in poor communities. outrage among concerned clinicians. Glyphosate can, to a large extent, be avoided adults are also highly vulnerable. by an organic diet that strictly excludes GMO Since 2012, almost 2,000 water systems In adults, lead exposure contributes to cardio- Glyphosate: A Rising Threat tested across 50 states were found to contain foods, since the vast majority of GM crops enter- vascular and kidney disease as well as cognitive ing our food supply are speci cally modi ed to levels of lead well above the EPA’s “action decline. In both children and adults, symptoms Glyphosate, the major herbicide used in today’s level” of 15 parts per billion (ppb). agriculture, poses heightened risk, since it is a withstand massive applications of glyphosate depend on the extent of exposure and may (the so-called “Roundup Ready” crops). Organic Some of the highest levels of lead were develop over a period of weeks or months. potent hormone disruptor with the potential for found in schools and daycare centers. Despite a wide range of detrimental physiological e ects. sources of poultry, meats, dairy products, oils and broad recognition of lead’s toxicity—espe- Lead Exposure & Oxidative Stress Glyphosate-based herbicides also contaminate fruits and vegetables should be encouraged. cially to young children—and identi cation drinking water via runo with a soil half-life Unfortunately “organic” does not guarantee Oxidative stress is a key mechanism in the patho- freedom from heavy metal contamination, so of its modes of entry into drinking water genesis of lead poisoning (Hsu et al. Toxicology. much longer than previously recognized. sources, over 4 million children are now at risk Glyphosate has been deemed “minimally buying from local organic farmers and growing 2002; 180: 33–44). Lead catalyzes oxidative reac- one’s own vegetables should be encouraged. of lead poisoning from municipal water sup- tions that generate reactive oxygen species. It toxic” by the food industry since the 1970s. plies (Bennett K, et al. Contemporary Pediat- More recently, it was authoritatively classi ed We can support the body’s complex network also inhibits enzyme reactions and impairs heme of detoxi cation mechanisms and pathways rics. 2015). production, inhibits production of sulfhydryl as a probable carcinogen by the World Health Lead and other heavy metals (such as mer- Organization (Guyton et al. Lancet Oncol. 2015; with vitamins, minerals, and natural compounds antioxidants, damages nucleic acids, and blocks in food. Microbiome support is also important, as cury, arsenic, and cadmium) can be excreted DNA repair. It triggers in ammation in vascular 16: 490–491). in urine and feces, but they cannot be metab- This compound is known to provoke oxida- many metabolic products of gut microbes pro- endothelial cells, and causes damage to cellular vide essential cofactors for the detox pathways. olized or eliminated e ciently by the body. membranes by directly binding to phospholipids tive disruption of mitochondrial metabolism. It Therefore, they accumulate in soft tissues and impairs serum sulfate transport, disrupts endo- Dietary choices that encourage detoxi ca- and stimulating lipid peroxidation. tion include organic fruits, vegetables, sea- bones, disrupting normal physiological func- Lead induced hypertension is directly crine signaling, binds to essential micronutrients, tions and impairing cardiovascular, immune, and may interfere with neurotransmission due to weeds, and sprouted whole grains containing related to free radical production and lower- high levels of enzymes along with vitamins, gastrointestinal, endocrine, urinary, and ner- ing of anti-oxidant reserves, both of which its similarity to certain neurotransmitters. vous systems. The inhibition of cytochrome P450 (CYP) minerals, ber and antioxidants. cause vasoconstriction. enzymes by glyphosate is an overlooked key to Foods that contain high amounts of sulfur its toxicity. By disrupting the natural detoxi ca- (cruciferous vegetables, onions, garlic, eggs, tion of foreign substances via CYP-mediated organic legumes, meat, and poultry) help pathways, it enhances the damaging e ects of counteract the e ect of glyphosate on serum other toxins in food and the environment. sulfate transport. Nutrients such as N-acetyl- Glyphosate-based herbicides are so preva- cysteine, alpha lipoic acid can further support Clinical® Synergy lent in the Western diet that a Statement of sulfur dependent detoxi cation pathways. Concern was recently issued by an interna- Detoxi cation formulas containing botan- Professional Formulas tional group of scientists and physicians (Myers ical extracts, particularly Ginkgo biloba, are et al. Environmental Health. 2016; 15: 19). useful in prevention of glyphosate toxicity, This is a world-wide problem; testing of and other botanicals such as milk thistle, arti- Europeans found glyphosate in the urine of choke, dandelion and burdock root can pro- 44% of people tested from 18 countries vide support for Phase I/Phase II pathways. (Friends of the Earth, June 2013). Mineral and vitamin cofactors including folic Consequences of glyphosate toxicity mani- acid, B12, B6, magnesium, selenium and zinc fest slowly over time, and may include cancer, provide essential support. infertility, birth defects, thyroid disease, kidney Modi ed Citrus Pectin (MCP) binds to toxins and liver dysfunction. Exposure can contribute to aid in their elimination. Often used in combi- to common conditions associated with a West- nation with alginates, MCP is a safe, natural, Helps reduce total body ern diet heavy on grains, fats, and processed selective chelator of heavy metals, and has been burden of heavy metals, foods: gastrointestinal disorders, obesity, dia- shown to decrease blood serum levels of lead, betes, heart disease, depression, autism, infer- as well as increase urinary excretion of lead, cad- such as lead, without tility, cancer and Alzheimer’s disease (Samsel mium, mercury and arsenic. Pectasol-C is the et al. Entropy. 2013; 15: 1416–1463). most extensively studied MCP (Eliaz et al. Phyto- side effects* ther Research. 2006; 20: 859–864; Eliaz et al. Detox Strategies Forsch Komplementarmed. 2007; 14: 358–364; The combined chemical load presented by Zhao et al. Alternative Therapies. 2008; 14(4): Features clinically food and water is daunting to consider. Living 34–38). Alginates have been shown to bind to a chemical-free life is practically impossible. numerous toxins in the gut as well as prevent tested, patented The additive e ects of multiple exposures reabsorption of toxins excreted in the bile. have not been well studied, but they are The take-home message is clear. There are ingredients cause for added urgency. thousands of toxic chemicals now found in our Addressing this key contributor to chronic environment, with the potential to accumulate health conditions in our patient population is in our bodies via food, air and water. The days of * an ongoing challenge and one that requires recommending a periodic “cleanse” for our ExcellentE safety profile innovative and practical solutions. In our prac- patients are over. They need lifelong strategies. tices, we need to go beyond classical medical In addition to our supervised intensive detoxi - management of lead poisoning, which is done cation protocols, daily mild detox should be an via intravenous chelation therapy. important part of our recommendations for any In children, chelation treatment is recom- condition, as well as for our healthy patients mended only for those having blood levels who need preventive recommendations. To Learn More, greater than 45 µg/dL (Kim et al. Annals of Occupational and Environmental Medicine. Isaac Eliaz, MD, is an integrative medical doctor, 2015; 27: 30). licensed acupuncturist, researcher, product for- Call or Go Online Today We have to ask why, if any level of lead is mulator and frequent lecturer. He has been a toxic, we are not advised to children with pioneer in holistic medicine since the early 1980s, www.clinicalsynergyformulas.com | 877.877.2362 lower values? In my opinion, this is because and has published numerous peer-reviewed there are no safe pharmaceuticals for the research papers. He is founder and medical direc- tor of the Amitabha Medical Clinic in Santa Rosa, Doctor Formulated • Research Driven pediatric population. And for adults, chelat- CA, an integrative center specializing in cancer, ing agents can have signi cant side e ects. Lyme disease, and other chronic conditions. He is *These statements have not been evaluated by the Food and Drug Administration. Clearly, safer, more natural solutions are also the founder and chief formulator of Clinical This product is not intended to diagnose, treat, cure or prevent any disease. needed for both pediatric and adult popula- Synergy, a company providing targeted, research tions. Chelation is generally recommended in based, physician-formulated nutraceuticals. Fall 2016 digestive health 7 Probiotics O er Bene ts Beyond the Gut Kullisaara et al. argue that ME-3’s capacity By Kristen Schepker to generate glutathione makes it “a perfect Contributing Writer protector against oxidative stress” (Kullisaara T, et al. Appl Biochem & Microbiology. 2010; Probiotics are widely touted for their capacity 46(5): 481–486). to improve digestive function and strengthen Complementing its antioxidant proper- gastrointestinal health. But according to new ties, glutathione supports immune health via research, the e ects of bene cial bacteria its role in the creation of white blood cells (Li extend far beyond the gut alone. Y, et al. Appl Microbiol Biotechnol. 2004; 66(3): In recent years, heightened interest in the 233–242). Additionally, glutathione produc- human microbiome has deepened scientists’ tion is associated with signi cant reductions in IL-6 and other proin ammatory cytokines understanding of the manifold bene ts that TM (Han S, Meydani S. 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ents 1): S74–S80). em tritional Suppl certain probiotic strains produce nutrients Nu A better, safer, and more convenient way to shop preactitioner-trusted for vitamins and supplements. Although glutathione is present in all Autoship Free that in uence our health system-wide. Shipping Express The gut microbiota, for example, acts as human cells, the liver is the primary pro- Checkout an important source of enzymes and vitamins ducer and exporter. Not surprisingly, the that humans can’t synthesize on our own, antioxidant also plays a critical role in the including vitamin K, and most of the water- detoxi cation process. It protects hepatic soluble B-group vitamins. Since our bodies cells from heavy metals including mercury, inherently lack these essential nutrients, it’s lead, cadmium, and other environmental crucial that we obtain them either through toxins, and also reduces tissue susceptibility the foods we eat or from the thankless e orts to toxicity from drugs like alcohol and of our intestinal ora (Rossi M, et al. Nutrients. acetaminophen. 2011; 3(1): 118–134). Researchers have linked glutathione de - Many common probiotics contain bacte- ciency to a range of disorders, including liver ria belonging to the genus Lactobacillus. One disease, cystic brosis, sickle cell anemia, HIV, strain—Lactobacillus helveticus CD6—makes AIDS, cancer, heart attack, stroke, diabetes, folate, a B vitamin whose many functions kwashiorkor, seizures, and Alzheimer’s and include DNA production and repair (Ahire J, Parkinson’s diseases (Wu G, et al. J Nutr. 2004; et al. J Food Sci Technol. 2013; 50(1): 26–34). 134(3): 489–492). Researchers recently discovered that Lac- Even in healthy individuals, the body natu- tobacillus fermentum ME-3, another unique rally begins to produce less glutathione over strain, produces a compound that possesses time. After age 20, production declines at a a striking array of powerful antioxidant, anti- rate of about 1% per year. microbial, anti-in ammatory, and detoxifying Antioxidant-boosting probiotics may properties. bene t those with low glutathione levels. L. fermentum ME-3 was rst isolated by a Some have suggested that because it’s a team of scientists led by microbiologist Marika peptide, oral glutathione supplements may Mikelsaar, MD, PhD, at the University of Tartu, be degraded by peptidase enzymes during Estonia. In their studies of Estonian children— digestion. who are known for their highly tolerant Probiotics like L. fermentum ME-3 o er a immune systems—Mikelsaar and her col- potential workaround, instead prompting the Things are different at Natural Partners... we’re leagues explored the possibility that probiot- body to produce essential nutrients from within. ics might play a role in the kids’ exceptional Last year, Essential Formulas Incorporated famously cheery for one, but we’re also passionate immune health. Indeed, they found a distinc- (EFI) debuted a line of probiotic ME-3 prod- tive microbial ngerprint among children with ucts in the US. The “formulations containing about helping you get the quality products you the most balanced immune systems. ME-3 are a truly groundbreaking scienti c Speci cally, they identi ed the L. fermen- advancement,” states EFI’s Director of Science, need in a simple, efficient way that you’ll love. tum ME-3 strain in one of their healthy young Ross Pelton, RPh, CCN. “The discovery and subjects. application of this probiotic is astonishing in We currently provide over 14,000 premium health Since then, continued studies on ME-3 its ability to produce the most e ective anti- conducted by Mikelsaar and others have oxidant in the human body.” products from over 180 trusted brands… anywhere shown this organism to confer a number of in the U.S. within two business days. And to help bene ts. Other Nutrient-Producing Probiotics For one, L. fermentum ME-3 acts as an anti- Alongside glutathione, L. fermentum ME-3 you better care for your patients’ diverse needs, microbial agent. Mikelsaar and co-author produces manganese superoxide dismutase Mihkel Zilmer, MD, PhD—another key con- (MnSOD), another intracellular antioxidant NP Script™ provides a fully customizable online tributor to the research on ME-3—write that boasting numerous health properties. when incorporated into dairy products like MnSOD is also antimicrobial, protecting store where patients can browse products and yogurt, cheese, and milk, L. fermentum ME-3 against a range of gastrointestinal patho- successfully suppresses pathogenic food con- gens. It can lower LDL cholesterol and purchase recommended items. Find out just how taminants including Salmonella, Shigella, and increase the activity of paraoxonase Staphylococcus. It can also reduce urinary enzymes, which help prevent lipid oxida- nice it is to have a friendly, helpful Natty P on the tract infections caused by E. coli. tion. Additionally, MnSOD reduces gut mem- They add that ME-3 can also increase the anti- brane permeability. other end of the line. Call Natural Partners today oxidant activity of blood serum, improve LDL MnSOD can withstand stomach and bile and post-prandial lipid composition, and defend acids, survives without refrigeration, and toll free 888.633.7620. against oxidative stress (Mikelsaar M, Zilmer M. doesn’t need to be enterically coated. Micro Ecol in Health & Disease. 2009; 21(1): 1–27). L. fermentum ME-3 is by no means the only probiotic strain that generates bene - A “Complete Glutathione System” cial substances for its human hosts. Entero- ME-3’s probiotic power derives largely from coccus faecalis TH10, a lactic acid bacterial its ability to produce glutathione. Often strain isolated from tempeh—a traditional referred to as the “master antioxidant,” gluta- Malaysian fermented soy food—produces thione is the most highly concentrated anti- 3-phenyllactic acid, a compound with anti- oxidant in the body. It exists inside every bacterial activity against various pathogens single human cell and serves a wide range of like Staphylococcus aureus and E. coli (Ohhira important bodily functions. I, et al. Biocontrol Science. 2004; 9(3): 77–81). Glutathione is made from the amino Human gut bacteria produce enzymes Toll Free 888.633.7620 acids glutamine, glycine, and cysteine. Most that profoundly in uence our nutritional naturalpartners.com often noted for its antioxidant properties, it metabolism. In one study, scientists exam- neutralizes free radicals, which are known to ined human fecal samples and identi ed 94 wreak havoc throughout many of the body’s di erent bacterial strains that were able to systems. metabolize gluten proteins. Their ndings, L. fermentum ME-3 supports healthy glu- the authors argue, could o er promising tathione levels in three key ways: synthesis, new treatment modalities for patients with uptake, and regeneration. First, it is able to Celiac disease (Caminero A, et al. FEMS directly synthesize glutathione on its own. Microbiol Ecol. 2014; 88(2): 309–319). When the antioxidant isn’t present, ME-3 can The above are just a few examples of the Now available in the USA also extract available glutathione molecules extraordinary range of healing bene ts that from the surrounding environment. probiotics o er. As the eld of microbiome exclusively from Natural Partners Additionally, ME-3 recycles oxidized or research continues to expand, so will our “spent” glutathione back into its active state. understanding of the vast role of bene cial Because it works along all three of these bacteria in supporting good gut, immune, pathways, scientists consider ME-3 to be a and overall health. “complete glutathione system.”
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The DII/FII is actually a new iteration of glycemia” (Bao J, et al. Am J Clin Nutr. 2009; an older tool. The first study to report on 90(4): 986–992). Insulin Index Helps Women the Insulin Index appeared in 1997 in the High GI scores correlate with high Insulin American Journal of Clinical Nutrition (Holt Index scores most—but not all—of the time. Get a Grip on PCOS, Weight Loss S, et al. Am J Clin Nutr. 1997; 66(5): 1264– Although the majority of high-GI foods also (Matsui S, et al. Int J Endocrinol Metab. 2013; 11(2): 1276). Since then, only a handful of addi- rank high on the II, there are several low gly- By Kristen Schepker 65–70). Hyperinsulinemia increases the produc- tional studies expanding upon the concept cemic foods that can prompt surprisingly of insulin scoring. high insulin surges. Dairy products, beef, and Assistant Editor tion of estrogen (la Marca A, et al. Fert & Steril. 2002; 78(6): 1234–1239). What’s the di erence between the Insulin sh are among a number of food categories Similarly, elevated insulin levels can also Index and the Glycemic Index? Several stud- noteworthy for their disproportionately For women su ering from insulin resistance, increase testosterone production. These phe- ies have compared the two. Though similar, higher Insulin Index values. a novel food classi cation tool may o er relief nomena occur when high levels of insulin sup- there are signi cant di erences. The Glycemic Early studies on the Insulin Index highlight from painful and worrisome symptoms. press the synthesis of SHBG, a protein that binds Index (GI) indicates how much a particular its potential e cacy in chronic disease treat- The new system, called the Dietary or to the sex hormones and inhibits their bioavail- carbohydrate-containing food raises one’s ment. Last year, researchers demonstrated its Food Insulin Index (DII or FII), ranks individual ability and functionality (Holte J. Baillière’s Clin blood sugar levels. The Insulin Index, on the validity as a useful tool for reducing elevated food items according to the insulin responses Endocrin & Metab. 1996; 10(2): 221–247). other hand, classi es foods based on their insulin in patients with type 2 diabetes, (Bell K, they induce. The greater the insulin demand Researchers have shown that insulin resis- e ects on insulin levels. The two are not et al. Am J Clin Nutr. 2015; 102(4): 801–806). a food exerts, the more it increases insulin tance is a signi cant risk factor for metabolic syn- always perfectly correlated. In women with PCOS, following a low- levels in the blood and, subsequently, the drome, a disorder that’s highly prevalent among higher its Insulin Index value. For example, the Glycemic Index system starch, low-dairy diet was found to promote females with Polycystic Ovary Syndrome (PCOS) doesn’t account for foods with little or no car- weight loss, improve insulin sensitivity, and The index compares the insulin responses (Roberts C, et al. Compr Physiol. 2013; 3(1): 1–58). to 1,000 kJ portions of speci c foods against bohydrate content. “It cannot provide a guide reduce testosterone levels (Phy J, et al. J Obes Tarkun et al. write that insulin resistance “is to the relative insulin response of a large Weight Loss Ther. 2015; 5(2): 259). that generated by consumption of a 1,000 kJ no doubt a key component of PCOS,” noting glucose reference. that both lean and obese women with PCOS majority of foods . . . including high-protein While the research is promising, it’s still As de ned by the National Institutes of exhibit insulin resistance and hyperinsu- foods such as meat, sh, poultry, eggs, and very limited. Considering the complex inter- Health, insulin resistance is a condition in which linemia (Tarkun, et al. J Clin Endocrin & Metab. cheese and high-fat foods such as butter and play of diet, lifestyle, and genetic factors on the body produces insulin, but doesn’t use it 2011; 89(11): 5402–5409). olive oil,” write Bao et al. insulin secretion, the management of insulin e ectively. In insulin-resistant individuals, the One of the hallmark traits of PCOS—a While carbohydrates spike blood sugar resistance is almost by necessity going to body’s muscle, fat, and liver cells fail to respond common hormone disorder a ecting girls levels, they are also the main drivers of insulin require multiple, overlapping strategies. Still, properly to the hormone, causing an excess of and women during their reproductive secretion, they’re not the only macronutri- the Insulin Index provides clinicians and glucose to build up in the bloodstream. years—is higher-than-normal testosterone ents that do so. “Protein-rich foods also elicit patients with an easy-to-use tool that can While the root causes of insulin resistance are levels. This hormonal imbalance can manifest a signi cant insulin response and, when com- help a diverse range of patients get a better not yet fully understood, researchers point to diet in an assortment of health challenges rang- bined with carbohydrates, act synergistically handle on the all-too-common problem of as a major contributor. High-fat and highly pro- ing from irregular menstrual periods and to raise insulin concentrations and reduce insulin resistance. cessed, carbohydrate-rich food items—in other infertility to excessive facial and body hair words, the basis of the standard Western diet— growth, skin issues such as acne, dark patches, trigger substantially greater insulin secretions and skin tags, and the development of large than do traditional diets comprised of less re ned numbers of cyst-like follicles on the ovaries. foods (Prescott J, et al. Cancer Epidemiol Biomark- PCOS is commonly treated using symptom- Insulin Resistance Improves ers Prev. 2014; 23(8): 1512–1520). relieving and hormone-balancing medica- tions. But these approaches do not necessarily Insulin’s Role in Women’s Health modulate the elevated insulin levels which on Paleo Diet Although it’s often discussed in relationship to often co-occur with PCOS. And since there’s no lipid levels, gene expression of key factors in diabetes, insulin can uniquely in uence wom- true medical “cure” for PCOS, lifestyle changes By Kristen Schepker en’s health in a variety of ways. A powerful fat metabolism and in ammation, insulin like diet modi cation are a critical component Assistant Editor resistance, and relative fatty acid composi- hormone itself, insulin is intricately connected of sustainable PCOS treatment. to the other hormones in the body, including tion in plasma. They also collected body sex hormones like estrogen and testosterone. How the Insulin Index Works Following a Paleolithic diet may help obese, measurements and proportions and physi- Changes in estrogen, testosterone, and sex Using the Insulin Index to guide food choices postmenopausal women lose weight and cal activity data. hormone-binding globulin (SHBG) levels are all is one strategy that may help PCOS patients lower their future risk for diabetes and car- After the 2-year intervention, Dr. associated with insulin resistance in females and others with insulin resistance. diovascular disease, according to a study Blomquist found that despite unlimited cal- presented at the Endocrine Society’s annual orie consumption, both study groups meeting in Boston earlier this year. showed similar levels of weight loss and sig- A dietary trend that’s gained increasing ni cantly less abdominal obesity. But the popularity in recent years, Paleolithic eating women who “went Paleo” showed improved focuses on the types of foods presumed to circulating fatty acid pro les, achieved bet- have been hunted and gathered by early ter metabolic markers, and showed increased humans. The so-called Paleo diet is com- insulin sensitivity, she reported. prised primarily of meat, sh, vegetables, Compared with those on the low-fat diet, and fruit, and excludes items that became the Paleo group showed a marked 19% commonplace after the development of decrease in “bad” saturated fatty acid intake, agriculture, such as dairy, grains and grain- while increasing their intake of healthy based products, and most processed foods. monounsaturated and polyunsaturated As the Paleo diet has risen in popularity, fatty acids by 47% and 71%, respectively. it has generated considerable controversy, Control group participants, on the other and very strong opinions on all sides. But hand, showed no signi cant changes in fatty there have been few well-controlled clinical acid consumption. Researchers found that SB Floractiv studies to test the impact of the Paleo speci c fatty acids associated with insulin approach. resistance were signi cantly lower among Caroline Blomquist, a doctoral student in women who followed the Paleo diet. Saccharomyces boulardii supplement the Department of Public Health and Clinical They also noted a decrease in delta-9-de- BioCeuticals SB Floractiv is a non-pathogenic biotherapeutic probiotic agent that Medicine at Sweden’s Umea University, and saturase activity among Paleo participants. supports the establishment of friendly bacteria in the gastrointestinal tract (GIT). colleagues, randomly assigned 70 obese, This liver enzyme is associated with liver fat, In the GIT, Saccharomyces boulardii increases the body’s production of secretory postmenopausal women with normal fast- insulin resistance, and mortality. IgA (sIgA), short-chain fatty acids and the activity of the brush border disaccharide ing plasma glucose levels to follow either a Blomquist concluded that “a Paleolithic- digestive enzymes. Paleolithic-type diet or a more typical low- type diet, high in polyunsaturated fatty acids, fat diet for 24 months. may have long-term bene cial e ects on Women in the Paleolithic diet group were obesity-related disorders, including reduced Clinical applications of SB: asked to consume 30% of their total energy risk for diabetes and cardiovascular disease.” • Gut rejuvenation – SB Floractiv primes the gut (E%, “energy percent”) in protein, 30 E% in Polyunsaturated fatty acids have previ- for microbial recolonization. carbohydrates, and 40 E% in fats with a high ously been shown to possess antioxidant, • Digestive health – Discourages the growth of unsaturated fatty acid content. anti-in ammatory, and antibacterial proper- harmful micro-organisms. The Paleo-style diet included lean meat, ties, o ering a host of bene ts in the treat- • Traveling – SB Floractiv is a heat-stable probiotic. sh, eggs, vegetables, fruits, nuts, and ber- ment of various chronic conditions, including • Works well with all antibiotics – SB Floractiv is an ries, plus rapeseed, olive oils, and avocado as cardiovascular disease, type 2 diabetes, antibiotic-resistant probiotic. additional fat sources. Dairy products, cere- some cancers, and obesity (Ouyang X, et al. • Supports gut healing – Increases body’s production als, added salt, and re ned fats and sugar Int J Mod Biol & Med. 2016; 7(1): 1–11). of sIgA, which helps to form a protective shield along were excluded. Additionally, by following Paleolithic gut lining. Subjects in the control group were in - dietary guidelines, participants essentially structed to eat 15 E% of their diet in protein, eliminated refined and simple carbohy- To order BioCeuticals products, 30 E% in fat, and 55 E% in carbohydrates. drates—which are known to contribute to please call Natural Partners toll-free at 888.633.7620 or visit They were encouraged to increase their overweight, obesity, and insulin resistance— www.naturalpartners.com intake of whole grains, consume low-fat dairy from their diets. products, and eat three servings of sh per “Obesity-related disorders have reached week. For both groups, total caloric intake pandemic proportions with signi cant eco- These statements have not been evaluated by the Food and Drug Administration. was unrestricted. nomic burden on a global scale. It is of vital These products are not intended to diagnose, treat, cure or prevent any disease. All subjects participated in 12 dietitian- interest to nd e ective methods to improve metabolic balance,” Blomquist added. For www.bioceuticals.com.au/us led group sessions and maintained records of their food intake. some patients, a return to a more ancestral BC_0030_SBFlora_US_180816_D1 At baseline, six, and 24 months, research- way of eating may be the key to better meta- ers documented participants’ circulating bolic health.
BC_0030_SBFloractiv_4.875x6.25in_US_Ad_180816_D1.indd 1 18/08/2016 11:52 AM Fall 2016 nutrition & lifestyle 9
Researchers have yet to establish whether Gojis will be as e cacious in mitigating the Goji Berries May Prevent Diabetic Retinopathy e ects of diabetic retinopathy in humans as in a trail mix of nuts and some pieces of dark However, they can be purchased for signi - they were in mice. In the meantime they By Julia Powers chocolate. They can be used in place of dried cantly less at Asian grocery stores. The bulk of make a delicious and nutritious addition to Contributing Writer cherries or cranberries to top a salad. the Goji berries sold in the United States are most peoples’ diet. The orange-red berries can be added to imported from China but now farmers in Cali- Julia Powers is a nutrition consultant and Tasty and nutrient-packed, Goji berries smoothies, used to top smoothie bowls, sprin- fornia, Nevada and New Mexico have begun to writer based in Hingham, MA. After earning her might a have a role in preventing retinal kled over oatmeal, or baked into mu ns. grow them. master’s in nutrition at the University of Bridge- damage associated with diabetes. Because they also have a tart quality, Goji Although Goji berries have been safely eaten port, she opted to further her education at the Also known as Wolfberries, Goji berries berries are also a tasty addition to rice, qui- for thousands of years, Dr. Lin notes that a few Maryland University for Integrative Health, are the fruits of the shrubs Lycium barbarum noa or grain dishes. case reports indicate that they may interact with where she is enrolled in the nutrition internship and Lycium chinense. These two closely The only slight downside is cost; since blood thinning drugs. Patients using these program. She also completed a ten-month related species are native to both Asia and they have been dubbed a “super food” in drugs should exercise caution before consum- mentorship program in Functional Medicine & areas surrounding the Mediterranean Sea. much of the popular press, Goji berries have ing Goji berries. Also be aware that the Lycium Clinical Nutrition, with Dr. Liz Lipski. In addition For over two thousand years, the fruit become quite expensive. Recently, a 16 oz. genus is part of the Nightshade family, so people to her private consultancy, Julia Powers Nutrition, package of organic Gojis was listed for with Nightshade allergies or sensitivities may she is a frequent contributor to Edible South and root bark of the plant have been used in Shore and South Coast magazines. Traditional Chinese Medicine. The orange- $16.79 on Amazon.com. also want to be careful with Goji berries. red berries, which are oblong and shriveled like raisins, can be eaten fresh but are more commonly found in a dried form. Sweet but tangy, Goji berries contain pro- tein, including all of the essential amino acids, iron, and Vitamins B1, B2 and C. They are also a good source of carotenoids, espe- cially zeaxanthin, flavonoids and polysaccharides. It is the carotenoid content that gives the berries a potential role in preventing dia- betic retinopathy, one of the most common and serious complications of both Type I and are a ected by acute digestive challenges. Type II diabetes. Over time, high blood sugar levels can damage retinal blood vessels. As the disease progresses, vision can become impaired and Should a maximum-strength probiotic be part of your protocol? the most severe cases can ultimately result in vision loss. Dr. Daniel Lin, Assistant Professor of nutritional science, and his fellow research- ers at Oklahoma State University of Human Accelerates the Proliferation of Healthy Intestinal Micro ora Sciences looked to the humble Goji berry to ascertain whether it could play a role in pre- Provides Intensive, High-Concentration Probiotic Support serving healthy retinal tissue. In a preliminary rodent study, Dr. Lin and his fellow researchers explored the impact of Promotes a Rapid Immune Response two of the carotenoids found in Gojis: zea- xanthin and lutein, both of which are highly concentrated in the macula of the eyes of Supports In ammatory Balance humans as well as rodents. For eight weeks, the researchers fed one group of mice a diet including 1% Goji ber- ries. A second group of similar mice got the same diet minus the Gojis. Using high per- formance liquid chromatography, the inves- Probiotic 225 is a maximum-strength probiotic for cases of acute tigators measured the carotenoid content of the retinal and liver tissue obtained from the gastrointestinal (GI) and immune challenges. Delivering 225 two groups of mice. billion active probiotic cultures per packet, Probiotic 225 creates a The mice fed the diet containing Goji ber- ries had a 13.7% increased concentration of rapid response to reset the immune system and promote zeaxanthin and lutein in both types of in ammatory balance. Each convenient, single serving packet tissue. To ascertain the e ect these carotenoids provides six proven strains chosen for their ability to survive the might have on diabetic retinopathy, Lin’s harsh GI environment and deliver superior results. group also examined the retinas of the mice. Just as in humans, hyperglycemia, such as can be found in poorly controlled diabe- tes, can lead to oxidative stress and mito- chondrial dysfunction, a primary marker of diabetic retinal degeneration. After eight weeks, the retinas of the mice Manufactured for maximum A broad-spectrum blend of Specialized strains selected for in the Goji berry group showed marked freshness, delivering superior proven strains, scientifically targeted GI and immune benefits improvement, with a complete reversal of potency for enhanced GI and selected for resilience, and their ability to survive the mitochondrial damage and improvements immune support endurance and effectiveness harsh GI environment in both mitochondrial dispersion and retinal epithelial pigment granules. As Dr. Lin observed, “the mitochondria get damaged and need to be recycled to prevent down- stream damage” and the goji berries GET A FREE BOX OF PROBIOTIC 225 appeared to do just that. go to OrthoMolecularProducts.com/pro225 Dr. Lin believes his research is the rst to show that “Wolfberry bioactive constituents O er Available to Quali ed Licensed Healthcare Providers prevented or delayed the onset of the dis- ease of diabetic retinopathy in an animal While Supplies Last Limit One Per Customer O er Expires November 30, 2016 model.” The researchers also found reduced hypoxia in retinal blood vessels of the mice fed the Goji berries. Since hyperglycemia For over 25 years, Ortho Molecular Products has partnered with health care providers to can cause hypoxia and subsequent vascular provide the very best supplements with an unwavering commitment to efficacy. dysfunction in people with diabetes, these intriguing ndings will hopefully encourage Evidence-Based Formulations. Uncompromising Raw Materials. Patients Get Better Faster. further research to determine if the berries will have the same protective e ects against To get started call 800.332.2351 or visit diabetic retinopathy in humans. OrthoMolecularProducts.com While the scientists work all of that out, there are plenty of other reasons to become These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. familiar with this nutrient-dense fruit. PRO2252016, Version 1.0 Chewier than raisins, and naturally sweet but not too-sweet, these orange-red berries are delicious eaten out of hand or included 10 chronic disease Fall 2016
The authors report that psoriasis cur- than 1 indicates a higher than expected Most of Otezla’s reported side e ects are Side E ects rently a ects some 7.5 million individuals in reporting rate for a given adverse e ect. minor (diarrhea, nausea and headache) cont’d from page 1 the US alone, while rheumatoid arthritis and though statistically important because they Crohn’s disease each affecting approxi- TNF Blockers: TNF blockers like Remicade, were reported more frequently than in the mately 1.6 million. Furthermore, the Crohn’s Enbrel, Humira, Cimzia and Simponi make other six drugs. Use of these seven drugs is soaring. The and Colitis Foundation of America reports up the largest category of anti-in ammatory However, Otezla had no reported inci- report estimates that in 2014, there was an that an additional 70,000 individuals are meds, with Humira and Enbrel at the top, dence of more serious side e ects common 8.5% increase in prescriptions over the previ- diagnosed every year. accounting for 80% of the market. These among other anti-in ammatories, such as ous year. The surge is being driven by condi- Because of the debilitating and progres- drugs function by blocking the action of TNF, cellulitis, dyspnea, intestinal perforation, tions such as rheumatoid arthritis and Crohn’s, sive nature of these and other in ammatory which is commonly elevated in in amma- latent tuberculosis, pneumonia and urinary which are on the rise across the nation. conditions, people with only moderate symp- tory conditions such as Crohn’s. tract infection. New guidelines limiting the use of opioid toms are typically eager to begin treatment. The most common complaint about both drugs are also playing a role, as practitioners Unfortunately, physicians often lack com- Humira and Enbrel is injection-site pain; Non-Rx Alternatives increasingly turn to anti-in ammatories rather plete information regarding the side e ects Enbrel has the highest ROR (19.15) for this The authors of the report underscore the than opioids to help attenuate patients’ pain. associated with certain drugs. e ect, followed by Humira (13.69). Both have importance of lifestyle changes, nutrition- “Unlabeled,” Yet Costly For instance, the Advera/Atlantic report comparable rates of less frequent but seri- based therapies, and holistic healing modal- notes that, “drug label inserts are generally cre- ous events like staph infection and myocar- ities in attenuating chronic systemic The Advera/Atlantic report is directed at ated based on clinical trail data, but such data dial infarction (Enbrel does not label in ammation, and reducing the need for insurance industry executives, however, its are often associated with serious publication myocardial infarction). risk-laden prescription drugs. content is equally pertinent to primary care bias issues. Furthermore, a Journal of the Ameri- While Humira and Enbrel are fairly similar, They cite a 2015 study from Yale School practitioners as it discusses many less fre- can Medical Association study of more than 100 when it comes to the top ve RORs for each of Medicine showing that beta-hydroxybu- quent but more costly conditions resulting clinical trials found that 65% of harms out- some di erences begin to appear. Humira’s tyrate (BHB), an endogenous compound from anti-in ammatory prescriptions. comes were incompletely reported.” top ve were: injection site papule (189.70), produced during fasting, inhibits NLRP3, Interestingly, the authors report that for The FDA’s FAERS archive contains useful intestinal fibrosis (not labeled [123.51]), which drives in ammation (Youm YH, et al. the ve costliest side e ects identi ed for information about real-world experiences with intestinal stula infection (49.04), synovioth- Nature Medicine. 2015; 21: 263–269). each of the seven drugs, about 24% of the drugs. However, accessing this information is esis (35.94) and stoma site pain (not labeled Researchers found that BHB can be pro- total cost is attributable to “unlabeled adverse often a complex, time-consuming process. All [33.54]). duced by any of the following: intermittent events”—side e ects that are not formally the data utilized for this study is sourced from Enbrel’s top ve RORs were: injection site fasting, high-intensity exercise, calorie restric- recognized or disclosed on the drugs’ warn- FAERS reports logged between January 2010 recall reaction (1,160.71), injection site tion or a low-carbohydrate ketogenic diet. ing labels and can be discovered only by min- and September 2014, and then consolidated warmth (71.75), injection site macule (53.44), While many patients suffering from ing post-market data. for ease of meaningful analysis. injection site swelling (42.48) and injection in ammatory conditions may not be able to Take staphylococcal infections. They’re site pruritus (35.57). undertake high-intensity exercise, low-carb not typically thought of as an adverse e ect Diverse Mechanisms Simponi is a relatively new option; at the diet or intermittent fasting may prove help- of anti-in ammatory use, and there’s no men- The various anti-inflammatory drugs are time of publishing there were only two years’ ful for them. Practitioners should also con- tion of this possibility on the drug labels. But often used interchangeably, but they do not worth of post-market data for the drug. It sider recommending diets high in they are linked, and they occur more fre- all have the same mechanism of action, and confers the highest risk of pneumonia com- anti-in ammatory foods and spices, such as quently than many physicians realize. the distinctions are important. pared with other drugs in this class. It was omega-3 rich sh, ax, green tea, ginger, tur- Advera estimates these infections, sec- The majority of anti-in ammatories are ranked second for the development of cel- meric and cayenne. ondary to use of anti-in ammatories, cost TNF blockers, but others function by inhibit- lulitis, behind Stelara. Also of note, myocar- Acupuncture can also play a role in miti- health plans over $50 million from 2010 to ing certain cytokines or enzymes. The Advera/ dial infarction, though not common, was a gating inflammation. In 2014, the World 2014, making it the costliest side e ect asso- Atlantic authors reviewed side e ects for serious possible side e ect not listed on Sim- Journal of Gastroenterology published a trial ciated with this drug class. each drug with speci c attention to mecha- poni’s label. of moxibustion acupuncture in individuals Stats like this highlight the need for careful nisms of action. Overall, the TNF blocker side e ects with suffering from Crohn’s disease. The study study of post-market data from independent Of particular interest was a list of the ve the highest RORs were: cell marker increase involved 92 medication-treated patients sources rather than relying exclusively on clini- highest reporting odds ratios (ROR) for non- (not labeled [81.21]), post-injection reaction with CD Activity Index (CDAI) scores rang- cal trials data provided by drug makers. disease related adverse e ects. A value greater (63.36), tuberculosis pleurisy (35.88), latent ing from 151 to 350. tuberculosis (35.51), and intervertebral disci- Patients in both groups came for treat- tis (23.48). ment thrice weekly for 12 weeks. The active Cimzia, when compared to the other treatment group received acupuncture seven drugs, showed high rates of abdominal based on TCM principles, using moxibus- pain and fatigue. Speci cally, fatigue was the tion with mugwort. The control group most frequently reported complaint, fol- received superficial acupuncture at non- lowed by abdominal pain and nausea (not meridian, non-acupoint zones and faux labeled). The top ve highest RORs were: non- moxibustion with wheat bran. infective bronchitis (490.13), ileocolectomy After 12 weeks, 70% of the treatment (not labeled [72.56]), rectal abscess (47.03), group had dropped their CDAI scores by perineal abscess (33.05) and frequent bowel more than 100 points; only 14% the control movements (not labeled [32.14]). group showed reductions of 100 points or “Infusion-related reaction” was the most more. Follow up observations at 24 weeks prevalent side e ect of Remicade, but vom- found that those treated with true acu- iting also was frequently reported. puncture had more stable long-term Several TNF blockers carry signi cant risk inflammation relief (Bao Chun-Hui et al. of intestinal perforation. Remicade had the World Journal of Gastroenterology. 2014; highest ROR for this side e ect (3.34), fol- 20(31): 11000–11011). lowed by Cimzia (2.81). The challenge of assuaging chronic pain and in ammation without introducing new Cytokine Inhibitors: Rather than blocking risks is a delicate balancing act to be sure. Phar- TNF, Stelara down-regulates in ammation maceutical scientists are certainly doing their by speci cally binding to the p40 protein part to improve the quality and safety of anti- subunit found on both interleukin (IL)-12 in ammatory drugs. Newer meds like Otezla and IL-23. This, in turn, lowers the rate of are de nitely less risky than older ones. natural killer cell activation. Otezla far outranked its competitors for Commonly reported side e ects for Ste- both safety and a ordability. However the lara included cellulitis and latent tuberculo- authors note that “although there are few sis. The number of cellulitis reports was signals for serious safety concerns to date, comparable to other drugs in the class. How- caution must still be taken given its rela- ever, out of the seven drugs reviewed, Ste- tively unproven post-market experience lara had a signi cantly higher ROR for latent when compared to Remicade, Humira and tuberculosis (116.82). Tuberculosis RORs for Enbrel.” Of those three, Enbrel had the few- the other six drugs ranged from 7 to 36. The est serious side e ects and lowest overall top ve highest Stelara RORs were: myco- cost associated with adverse e ects. bacterium tuberculosis (126.51), latent One new drug, not included in the review, tuberculosis (116.82), cholangiocarcinoma which the authors suggest keeping an eye (44.05), malignant melanoma in situ (43.35), out for is Cosentyx; it is poised to compete and keratoacanthoma (32.13). with Stelara as a once monthly treatment option. Enzyme Inhibitors: Otezla reduces in am- Still, pharmaceutical solutions are expen- mation by inhibiting the intercellular sive, as is clearly demonstrated in this report, enzyme PDE4. It was the newest drug evalu- and they do little to resolve the fundamental ated in the Advera/Atlantic study. physiological imbalances driving chronic Otezla is a promising new option, both in ammatory states. In this context, the glar- because it has the lowest price point of the ing need for practitioners who can bring a seven, and because of its ease of use: it is a comprehensive holistic approach has never pill, not an injection. been more clear. Fall 2016 chronic disease 11 Omega-3s Plus Curcumin—An E ective Equation for In ammation EPA and DHA reduce pro-in ammatory signals” in the elderly (Gangemi S, et al. Exp IL-1beta, and the enzyme matrix metallo- By Kristen Schepker cytokines, proteins involved in the in amma- Gerontol. 2005; 40(7): 612–614). proteinase-9, while increasing the anti- Assistant Editor tory process that can also contribute to pain Older age is also associated with chroni- inflammatory cytokine IL-10, as well as the associated with conditions like rheumatoid cally elevated circulating levels of interleukin antioxidant enzymes superoxide dismutase, arthritis (Zivkovic A, et al. Calif Agric (Berkeley). (IL)-6, tumor necrosis factor (TNF), IL-1 recep- catalase, and glutathione peroxidase (Kant V, In recent years, spending on prescription 2011; 65(3): 106–111). tor antagonist, and C-reactive protein (CRP). et al. Int Immunopharmacol. 2014; 20(2): anti-in ammatory drugs has soared. Unfortu- Additionally, omega-3s promote the bio- While persistent in ammation appears in 322–330). nately, it’s become clear that the price paid synthesis of lipoxins, resolvins, and protectins, many di erent chronic diseases, plasma lev- Curcumin is widely available, inexpensive, doesn’t end with the drugs themselves; the which themselves possess anti-in ammatory els of IL-6 correlate with increased age, inde- and has an excellent safety pro le, making it side e ects they cause—which can range and pro-resolution properties. These mole- pendent of chronic disease states. Levels of a stellar option for side e ect-free in amma- from fatigue and pain to severe infections— cules work to both control acute in ammatory circulating in ammatory markers in older tion treatment. But the therapeutic use of are very costly (see “Anti-In ammatory Drug responses as they occur and stimulate the adults are, on average, two- to four-fold curcumin has been somewhat limited by its Side-E ects Carry High Price Tag,” page one). resolution phase of in ammation. higher than in younger adults (Kale S, Yende low bioavailability. It is poorly absorbed, Fortunately, a number of natural therapies Previously de ned as a passive process, S. Aging Dis. 2011; 2(6): 501–511). quickly metabolized by the liver and intes- can o er tremendous anti-in ammatory poten- the resolution of in ammation is now under- Omega-3 fatty acids can certainly help tines, and rapidly eliminated from the body tial without the unwanted consequences. stood to be a distinct and active second set attenuate age-related in ammation, as well (Shaika J, et al. Euro J Pharm Sci. 2009; 37(3–4): Two of the best-known non-prescription of biochemical actions (Serhan C, et al. Nat as more severe pathological in ammation 223–230). treatments to reduce inflammation are Rev Immunol. 2008; 8(5): 349–361). Omega- associated with speci c disorders. Curcumin Asian medical traditions like Ayurveda omega-3 fatty acids and curcumin, both of 3s and their byproducts appear to support o ers similar anti-in ammatory bene ts. It is overcome this absorption problem by com- which can be obtained from food as well as both steps. a naturally occurring antioxidant with tre- bining turmeric with healthy fats and mixing nutritional supplements. Disruptions in the in ammation resolu- mendous utility in treating many forms of it with black pepper—the main component Recently, Nordic Naturals—a company best tion process can a ect disease etiology. In in ammation. A primary biochemical con- of which is piperine, a compound that known for its high quality sh oils—developed one study, researchers linked the ine cient stituent of turmeric, a widely used Asian enhances curcumin’s bioavailability. Black an innovative formula that combines omega- biosynthesis of key omega-3-derived resolu- spice, curcumin has long been utilized as a pepper and turmeric go together in most 3s with curcumin to optimize the antioxidant tion mediators to increased obesity-related health-promoting nutrient. Indian curry powders. and in ammation-mediating e ects of both. in ammation and insulin resistance. As with omega-3s, scientists have demon- Modern biochemists have explored a vari- Called ProOmega CRP, the formula com- In omega-3-de cient mice fed a high-fat strated curcumin’s therapeutic potential in ety of di erent methods for formulating cur- bines concentrated omega-3 sh oil, cur- diet, the resolution mediator protectin D1 was numerous chronic illnesses characterized by cumin for maximum clinical e cacy. The cumin, and the powerful antioxidants lacking in the animals’ muscle and adipose tis- in ammation, including Alzheimer’s and Par- trademarked Longvida free-form curcumin L-Glutathione and N-Acetylcysteine. A com- sue, impairing the capacity to resolve acute kinson’s diseases, multiple sclerosis, epilepsy, present in ProOmega CRP uses a patented pany press release states that “Together, in ammation. These e ects, the investigators cerebral injury, cancer, allergy, asthma, rheu- delivery system developed by UCLA research- these nutrients work within cells, tissues, and noted, were reversed when omega-3 levels matoid arthritis, diabetes, obesity, depres- ers to increase curcumin absorption. organs throughout the body to maintain were restored, preventing the development of sion, and AIDS. Nordic Naturals notes that this form is over healthy antioxidant status and normal meta- in ammation and insulin resistance (White P, Curcumin reduces inflammation 65 times more absorbable than others and bolic activity, ne-tune critically important et al. Diabetes. 2010; 59(12): 3066–3073). through multiple pathways, some of which promotes the movement of curcumin into cell signals, and help eliminate both internal De ciencies in pro-resolution molecules aren’t affected by omega-3s. Aggarwal and the lymph and then the blood, allowing levels and environmental toxins.” occur simply as part of the natural aging pro- Harikumar note that the compound regu- of unmodi ed curcumin to be sustained for a Most commonly found in sh and plant cess. Researchers have shown that when com- lates several inflammation-related tran- more biologically meaningful period of time. oils, omega-3s boast numerous health-pro- pared to younger people, elderly individuals scription factors, cytokines, protein kinases, This form of curcumin also eliminates the moting properties, among them an ability to have decreased levels of the anti-in amma- adhesion molecules, and enzymes that are need for piperine, which, while improving lower in ammation in the body. Mounting tory, pro-resolution arachidonic acid metabo- linked to in ammatory processes (Aggarwal B, curcumin absorption, may cause certain com- evidence links omega-3 supplementation to lite lipoxin A4, and elevated levels of Harikumar K. Int J Biochem Cell Biol. 2009; pounds—including pharmaceuticals—to improvements in a wide array of in amma- pro-in ammatory cysteinyl leukotrienes. There 41(1): 40–59). remain intact and active in the body longer tion-linked conditions, including osteoarthri- is a signi cant inverse correlation between age In one study, investigators found that than typically expected. tis, cardiovascular disease, cancer, lung and and the lipoxin A4/cysteinyl leukotrienes ratio, applying a curcumin-based gel to cutane- Together, the omega-3/curcumin supple- kidney disease, metabolic syndrome, and meaning that an age-associated switch in ara- ous wounds accelerated healing in diabetic ment combination o ers a promisingly safe neurodegenerative disorders like Alzheimer’s, chidonic acid metabolism prevents the forma- rats by decreasing expressions of the pro- and e ective alternative to pharmaceutical to name just a handful. tion of crucial in ammatory reaction “stop inflammatory cytokines and TNF-alpha and anti-in ammatories.
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Your partners in 800-525-7372 PERQUE.com 800-553-5472 INTEGRATIVE HEALTHCARE ELISAACT.com for over 20 years! 12 herbal medicine Fall 2016 Mushroom-Derived Compound O ers Promise for Chronic Fatigue Patients 59% had improvements in physical symp- While research is in the preliminary stages, 4: 37–39). One study, in which mice By Sara Lovelady toms, and a whopping 81% had improved there’s reason to get excited about AHCC. The were infected with the flu, showed flu- Contributing Writer mental function. The longer the treat- compound is an extract of shiitake mush- related death rates of 25% in untreated ment, the better the response (Watt T, et al. room (Lentinula edodes) mycelium, which is animals, but only 5% in the animals J Med Virol. 2012; 84: 1967–1974). very rich in glucans. All medicinal mushrooms given AHCC (Ritz BW, et al. J Nutr. 2006; A glucan-based compound derived from Shii- • A double-blind, clinical trial of 30 CFS contain glucans, but the alpha-glucans in 136: 2868–2873). Similarly, animals take mushrooms might provide a sorely patients, who also had elevated HHV-6 AHCC appear to have greater immunostimu- infected with the West Nile virus were needed new option for people with chronic and EBV antibodies, showed that com- latory potential than the beta-glucans found twice as likely to survive when treated fatigue syndrome. pared with placebo, treatment with val- in other types of mushrooms. with AHCC (Wang S, et al. J Nutr. 2009; Known as Active Hexose Correlated Com- ganciclovir for six months relieved mental Due to a patented manufacturing process, 139: 598–602). pound (AHCC), this compound has both fatigue and improved cognitive function the alpha-glucans are also smaller, which • Two randomized, controlled studies of immune-enhancing and direct antiviral (Montoya JG, et al. J Med Virol. 2013; 85: makes them easier to absorb into the healthy adult humans have shown AHCC e ects, particularly against Human Herpesvi- 2101–2109). bloodstream. increases the e ectiveness of the u vac- rus 6 (HHV-6), a pathogen that has been • Finally, a study of 15 preteens and adoles- AHCC, which was discovered and devel- cine by improving antibody response linked with CFS in some studies. cents with treatment-resistant depression oped in Japan several decades ago, has been (Roman BE, et al. Nutr Res. 2013; 33: 12–17. CFS is a common, vexing, and poorly and CFS found that anti-viral treatment studied extensively and is currently in use in Gardner E, et al. Presented at Experimental understood condition characterized by per- produced positive results in 93% of the 700 clinics worldwide as a standard preventa- Biology meeting. April 2010). sistent fatigue not relieved by sleep, and last- subjects (Henderson TA. Adv Mind Body tive regimen to reduce the risk of infection. • A double-blind, placebo-controlled trial of ing at least six months in adults or three Med. 2014; 28: 4–14). Oral ingestion of AHCC stimulates the pro- 39 patients with the hepatitis C virus months in children or teens. People with CFS duction and the activity of several important found that AHCC helped stabilize the con- often su er from muscle and joint pain, as While there’s still much more scienti c work needed before we can de nitively con- components of the immune system, includ- dition in the treatment group, while those well as muscle weakness, low motivation and ing various cytokines, natural killer cells, mac- in the control group declined (Thaiudum S, mood, and curtailed activity. clude that CFS has a viral cause, the aggre- gate clinical evidence is hard to ignore. rophages, T cells, dendritic cells, and B cells. In Piyaniran W, Chuaputthi A. The Medical The disorder likely has multiple causes, Japan, and elsewhere, AHCC has been used in News (Thailand). 2010; 325: 13–16). but since the late 1980s, the prevailing scien- There is also evidence that immune system dysfunction may underlie CFS. Two studies pub- the treatment of liver, gastric, colon, prostate, ti c view is that viral infections are a key fac- and breast cancer. tor (Komaro AL, et al. J Rheumatol. 1989; lished earlier this year have found that patients AHCC & CFS 19(Suppl): 23–27). Suspected viruses include with CFS have defective natural killer cell and AHCC’s Anti-Viral Action What does all of this have to do with chronic the Epstein-Barr virus (EBV) and two strains of invariant natural killer T cell function (Petty RD, fatigue? et al. PLoS One. 2016 Mar 11; 11(3): e0150904; There is good evidence that AHCC is active the herpes virus (HHV-6 and HHV-7). against a number of viral pathogens: While AHCC has not yet been speci cally Ramos S, et al. Asian Pac J Allergy Immunol. 2016 studied in connection with CFS, the fact that The CFS Viral Hypothesis Mar 20. 10.12932/AP0733). • Cancer patients undergoing chemother- it has signi cant impact on two of the main It’s interesting to note that natural killer apy are vulnerable to infection with HHV- factors influencing the development of There is certainly some convincing evidence that cells play a major role in resolving the acute 6, so researchers studied a group of 29 CFS—common viral i nfections, and underly- viruses contribute to the development of CFS. phase of HHV-6 infection (Kumagai T, et al. such patients who took AHCC during their ing immune system de ciencies—support • One study initially found no di erence in J Med Virol. 2006 Jun; 78(6): 792–799). second stint of chemotherapy but not the notion that this supplement could be prevalence of HHV-6 or HHV-7 infection It may be that it is the underlying immune during the rst. Levels of the virus in bene cial to people with this condition. between CFS patients and healthy subjects. system de cit that renders people more vul- patients’ saliva rose signi cantly during Anecdotally, CFS patients taking the However, when the researchers considered nerable to viral infections, with the CFS pat- the rst course of chemotherapy, but fell research-supported dose of 3 grams AHCC people infected with both the HHV-6 and tern emerging as a long term downstream signi cantly during the second course daily for at least six weeks do report symptom HHV-7 virus, they found a signi cant correla- consequence. when they were also taking AHCC (Ito T, improvements across multiple parameters, tion with CFS (Chapenko S, et al. J Clin Virol. et al. Nutr Cancer. 2014; 66(3): 377–382). especially if the CFS is viral-related. 2006; 37(Suppl 1): S47–S51). Mushroom Compounds & • Animal research suggests AHCC may be On the safety side, AHCC is one of the • A review of CFS patients receiving the Immune Stimulation effective against the West Nile virus and most well-studied natural products on the antiviral drug, valganciclovir, for HHV-6 Beyond antiviral drugs, is there a natural alter- at least two strains of the flu, including market. The research shows a consistent pat- and/or EBV found over half responded native to address the underlying viruses that the H5N1 (bird u) virus (Fujii H, Nishioka H, tern of safety with few if any signi cant side well to the treatment. Of those helped, may contribute to CFS? et al.Jap J Complement Altern Med. 2007; e ects.
(Russo E, et al. Neurochem Res. 2005; 30(8): 1037–1043). Is Marijuana a Viable Remedy for Migraines? Each of these pathways appear to in u- Marijuana contains numerous cannabi- where they regulate such cannabis-driven ence migraine development, possibilities that By Kristen Schepker noid compounds, several of which have been effects as decreased motor activity, pain researchers continue to explore today. Assistant Editor shown to reduce in ammation in the body. relief, and feelings of relaxation and wellbe- Although randomized clinical trials on can- ing. These receptors are also found in periph- nabis or CBD for headache treatment are cur- Anti-In ammatory E ects eral neurons, where their activation slows rently lacking, the existing medical marijuana In recent years, both an upsurge in medical Tetrahydrocannabinol (THC), the most well- neurotransmitter release in the heart, blad- studies suggest great promise for migraine cannabis research and also changes in the known cannabinoid, lowers in ammation der, intestine, and vas deferens. and headache su erers. Some researchers plant’s legal status in many US states have led through various mechanisms; it inhibits the CB2 receptors have been detected outside have even argued that marijuana’s e ective- health practitioners and patients alike to shift synthesis of prostaglandin E2 (PGE-2), a lipid the CNS, predominantly in immune system ness in treating pain could profoundly in u- their views of cannabis from goofy recre- mediator that contributes to in ammatory cells, from which they’re presumed to mediate ence public health for the better. ational drug to serious medicine. pain; decreases the aggregation of platelets, cannabinoid-induced immunosuppression According to a study published this Currently, 25 states plus the District of which, when activated, play a role in regulat- and anti-in ammatory e ects (Nocerino E, et summer, states in which medicinal mari- Columbia have legalized medicinal mari- ing the in ammatory cascade; and stimulates al. Fitoterapia. 2000; 71(Supp 1): S6–S12). juana is legal have experienced notable juana, while others only permit use of canna- lipoxygenase, which promotes down-regula- reductions in prescription drug use, making bidiol (CBD), a non-psychoactive cannabinoid tion of in ammation (Canavan B, et al. J Clin Endocannabinoids, Serotonin a case for cannabis as a possible strategy to extracted from the cannabis plant. Endocrinol Metab. 2005; 90(10): 5779–5785. & Migraines address the country’s marked opioid epi- The rapidly-growing body of medical can- Russo E. Neuroendocrinol Lett. 2008; 29(2): Researchers have proposed that dysfunction demic (Bradford A, Bradford W. Health Aff. nabis research illustrates its e ectiveness in 192–200). of the endocannabinoid system may in u- 2016; 35(7): 1230–1236). treating a wide range of illnesses. Among the Greco and Tassorelli note that THC has 20 ence migraine pathogenesis in several ways. A Long, Strange Trip more recent discoveries is the e cacy of can- times the anti-in ammatory potency of aspi- One appears to be through its interactions nabis and cannabis-derived compounds for rin and twice that of hydrocortisone (Greco R, with the body’s serotonergic system. In a Scienti c signals indicating that cannabis the treatment of migraines and other forms Tassorelli C. Endocannabinoids and migraine. study of patients with chronic migraines and may have a role in ameliorating headaches is of chronic headache. In: Fattore L, ed. Cannabinoids in Neurologic medication-overuse headaches, investiga- merely the latest paragraph in the long, Eric Baron, DO, author of a comprehen- and Mental Disease. 1st ed. Academic Press; tors linked endocannabinoid system impair- meandering tale of this plant’s history with sive review of medicinal marijuana pub- 2015). ment to a reduction in patients’ serotonin human beings. lished last year in Headache: The Journal of A number of researchers also point to levels (Rossi C, et al. Euro J Clin Pharm. 2008; One of the earliest plants cultivated by Head and Face Pain (Baron E. Headache. marijuana’s interactions with the endocan- 64(1): 1–8). man, evidence of the rst use of cannabis as 2015; 55(6): 885–916), contends that “physi- nabinoid system as a key source of its pain- While serotonin’s exact role in headache medicine dates back to ancient China and cians need to be educated on the history, relieving capabilities. The term pathophysiology isn’t fully understood, it is India. Though it was clearly documented as pharmacology, clinical indications, and “endocannabinoid” was coined in the mid- widely recognized as “a key molecule in the an herbal therapy for centuries in Asia, and proper clinical use of cannabis, as patients 1990s after scientists discovered that the neurobiology of migraine.” There is evidence used in Greece, Rome, and throughout the will inevitably inquire about it for many body contains its own internal cannabinoid that migraine patients experience “altera- Islamic empires, it was not until the 19th cen- diseases.” receptors both in and outside of the central tions in serotonergic neurotransmission,” tury that cannabis made its way into the Pain relief ranks among the drug’s most nervous system (CNS). with many exhibiting low cerebral serotonin Western medical realm. common uses, with headaches often cited by It’s now understood that the endocan- levels between headache occurrences and European physicians prescribed it in the marijuana users as a top health issue for nabinoid system comprises not only the can- elevated levels during migraine attacks treatment of various conditions, headache which they use cannabis to seek relief. nabinoid receptors, but also endogenous (Deen M, et al. Published online March 23, and migraine among them, and eventually Science is beginning to support this pat- ligands and enzymes for ligand biosynthesis 2016. Cephalalgia. 2016). the herb’s reputation as a healing agent tern of use. A study published earlier this year and inactivation. CBD appears to be one of the cannabi- reached North America. By the middle of the was one of the rst to con rm a decrease in Many researchers today recognize that noids that interacts with the body’s seroto- century, more than 100 scienti c articles the frequency of patients’ migraine head- this system as a whole “seems to be involved nergic system. Russo et al. explain that CBD detailing its therapeutic value were published aches associated with medical marijuana in an ever-increasing number of pathological both inhibits serotonin re-uptake and reduces in Europe and the US, highlighting its e ec- treatment (Rhyne D, et al. Pharmacother. conditions” (Di Marzo V, et al. Nat Rev Drug serotonin neurotransmission. “There is also tiveness as an analgesic, sedative, and diges- 2016; 36(5): 505–510). Disc. 2004; 3(9): 771–784). some experimental evidence to support tive aid, alongside numerous other uses. Many researchers argue that the ability of The two types of cannabinoid receptors CBD’s activity in other neurotransmitter sys- Several US-based laboratories, including cannabis to help quell headaches is in part are referred to as CB1 and CB2. CB1 receptors tems such as dopamine, GABA, and the Bristol-Meyers Squibb, Parke-Davis, and Eli due to its anti-in ammatory properties. are found in both the central nervous system, endogenous opioid system,” the authors add see next page Fall 2016 psyche & soma 13
and smarts to reach the goal, and would do same group also generally likes the idea of a authority. The hierarchy is: God above Man, Neurobiology of Politics so were it not for an uncontrollable variable at tax and tort reform but tends to oppose Man above Nature, Men above Women, the cont’d from page 1 like gender, race, ethnicity. Thus it evokes environmental regulation. Similarly, people Disciplined (Strong) above the Undisciplined anger at unfairness. who advocate gun control usually oppose (Weak), the Rich above the Poor, Employers 1/10 of one second before it becomes con- These two simple words engage a myriad tort reform, but identify as pro-choice on above Employees, Western culture above oth- scious, and it will change in that 1/10 of a sec- of neurological pathways. abortion. ers, America above other countries. ond to t what you already know or believe. Lako says complex metaphors like this On face value, the issues are unrelated. When facts come in that do not t the way begin with simple bodily realities. The notion There’s no obvious reason they should constel- The Nurturing Parent model: This model, you already understand the world, they will that more is up, and less is down begins when late so closely. prevalent among Democrats and liberals, go unseen, or will be ignored, ridiculed, or a child sees that adding liquid to a cup makes “I started asking why conservatives always emphasizes empathy over obedience, con- attacked,” he explained. the uid level rise, while pouring it out makes talk about ‘family values’ and what those val- sensus over command, relativism over hierar- The frames through which we perceive are it go down. Simple enough, but few people ues consist of. What I found is that we have a chy. In this view, authority is not gendered culturally conditioned and largely uncon- are conscious that this is the basis of a vertical big cultural metaphor that the nation is a nor is it God-given. It is merited, not ordained. scious. They create rules, roles, and expecta- metaphor like “skyrocketing healthcare costs.” family. It makes sense, because for all of us Good parents teach children how to be tions. Take a simple example: the word Similarly, the use of temperature terms to the rst experience of being ‘governed’ is in compassionate and responsible to others. “hospital.” describe emotionality has roots in infancy. the family.” From this comes the “ethic of excellence”— Anyone beyond the age of six knows what “When you are held as a child and you simul- People across the political spectrum share the vision of teaching children to be the best a hospital is and what happens there—even taneously feel a ection and warmth, your this unconscious “Nation as Family” meta- they can become, not out of fear of punish- if he or she has never been to one. We all brain is activated in two places. The more phor. But conservatives and liberals hold dif- ment but out of a desire to do good. It’s an know that people go there when they’re sick. they’re activated the stronger that associa- ferent frames and narratives on what a family aspirational rather than punitive approach. Doctors and nurses with special knowledge tion gets, until those brain centers nd the should be. Lako observes two basic family In the Nurturing Parent view, protection, and tools take care of them. Other kinds of shortest path and form a circuit, which ulti- models that get metaphorically projected security and prosperity arise not from domi- people make sure this occurs in an orderly mately manifests as metaphor.” Thus, we talk into the political sphere: nance but from mutual understanding, way. about a “warm welcome” or a “cold shoulder.” negotiation, compromise, and rational prob- All this—and more—is instantly evoked The Strict Father model: This is the vision lem-solving. Instead of a strict hierarchy, the by that one word. From Primal Reasoning to Politics epitomized by in uential conservative groups ideal world is one of inter-connected net- Breaking a frame causes discontent. Metaphors like this are primary, physical, and like James Dobson’s Focus on the Family. It works of diverse, empowered people. Fair- “Imagine you walk into a hospital to visit a rooted in survival, says Lako . We all form holds that a strict father is necessary to sup- ness, freedom, tolerance and social justice friend and the receptionist gives you a scalpel hundreds by the time we’re 6 or 7 years old. port, protect, and direct a family. This is a are the keywords. and ushers you into an OR where there’s a Descartes was wrong to suggest reason is dis- man’s job, and the woman’s role is to support doctor on the table. You know something is embodied or dispassionate. In the absence of and enforce the father’s leadership. Both models have strengths—because both wrong because that’s not what’s supposed to emotion, reason falters. The Strict Father view holds that children evolved through thousands of years of happen,” says Lako . In his book Descartes’ Error, neurologist are essentially born “bad” in that they just human survival struggle. They also have limi- There can be more or less agreement Antonio Damasio describes people with dam- want to do what feels good. They have to be tations and blind spots. about the meaning of a given frame. For “hos- age to brain regions connected with emotion taught right from wrong. The most e ective In reality, most people have unconsciously pital,” there’s strong consensus. But what and empathy. They do not become super- way to do this is via physical punishment. internalized both models to varying degree. about a frame like “family”? rational like Star Trek’s Mr. Spock. On the con- Dobson holds that punishment must be pain- Someone might show a Nurturing Parent Along with frames, our reasoning is gov- trary, they are incapable of rational decision. ful enough so a kid learns to avoid “wrong” style at work, but play out Strict Father erned by metaphors, which seem simple but “If you can’t feel emotion—yours or others— and develops discipline to do “right.” A father dynamics at home. are neurologically complex. Take the idea of how would you know what to want? You has a moral duty to administer necessary While individuals are often “bimodal,” Lako the “Glass Ceiling.” wouldn’t be able to decide what to do in any punishment, though he should not enjoy says political campaigns tend to posit the two Because a ceiling is “above,” the metaphor situation,” Lako says. causing pain. models as incompatible opposites. When push is based on verticality as indicator of success, While the capacity to create frames is bio- This family model emphasizes obedience. comes to shove—as it does in an election— so it involves brain centers that process spatial logically hard-wired, the process of de ning It’s the “This is not a democracy!” approach. The people tend to polarize. relations. The image suggests purposeful and linking them is learned. It is social—and father’s discipline, reinforced by the mother, is motion toward a destination, which implies ultimately political. supposed to become internalized self-disci- Poverty, Prosperity & Morality desire. Since it signi es a goal clearly seen but A person’s self-identity and “world view” pline, which makes a person strong enough to When the Strict Father model is applied politi- invisibly blocked, it triggers frustration. are based on cultural narratives learned from succeed and prosper in “the market.” cally, “Father-as-decider” becomes “let the market Finally, it implies that the striver has the skills others. These are, essentially, chains of meta- The Strict Father world is a well-ordered decide.” Ultimate paternal authority is conferred phors linked to create stories and character moral hierarchy; those who traditionally onto the “free market,” Lako explains. The types. Our culture is lled with them: rags to dominated should dominate owing to moral see Neurobiology p. 14 Lilly, produced cannabis extracts and tinc- riches; the underground railroad; striving tures for medicinal purposes (Zuardi A. Rev. immigrants; victorious underdogs; intrepid Bras. Psiquiatr. 2006; 28(2): 153–157). pioneers; lovable rogues; virtuous outlaws; Since then, the plant has taken “a fascinat- the champion of the common man; the tor- ing journey from a legal and frequently pre- tured genius; the rugged individualist who scribed status to illegal, driven by political and social factors rather than by science,” “pulls himself up by his bootstraps.” writes Dr. Baron, a neurologist at the Cleve- Hate His Policies, Love Him land Clinic, Lerner College of Medicine. Through the beginning of the 20th cen- Political gures become symbols of these tury, cannabis retained its stature as an metaphors. For many people, Barack Obama important part of the Western pharmaco- embodied the underdog myth, beating the poeia. Soon thereafter, however, its use racial odds to become the rst Black presi- declined signi cantly, a trend attributable to dent. Reagan was a beloved workingman’s various factors including legal restrictions hero. John McCain is the loyal soldier who limiting its medical prescription and experi- sacri ced for freedom. Many see Hillary Clin- mentation, as well as the development of ton’s candidacy as the epitome of the glass e ective new drugs like aspirin, which carried ceiling drama. indications similar to those of marijuana. More than speci c policies or issues, peo- In the second half of the century, the herb ple vote for mythology and metaphor. It is not see Neurobiology of Politics p. 14 re-appeared on the scene in the US, but this a conscious process, but Lako says it de - time largely for recreational use. It was in the nitely has its own logic. 1930s that the drug became criminalized. It Early on in Ronald Reagan’s rst presiden- was also at that time that the name “mari- tial bid, his chief strategist, Richard Wirthlin, juana”—the etymology of which is obscure noticed a curious phenomenon: many Ameri- but thought to derive from Mexican slang— cans strongly disliked Reagan’s policy stances, Couldn’t Join Us In San Diego? supplanted the term cannabis. Despite its but they liked him—and would vote for him long history as a healing agent, by mid-cen- despite their reservations. Wirthlin sought to tury, this plant’s therapeutic value was largely Audio and Video Recordings overshadowed by its growing stigma as an understand this. illicit substance. He found that when it came down to it, NOW AVAILABLE! That stigma remains connected with voters didn’t really care about “issues”. They cannabis today. Despite increasing studies cared about five things: Values, Communi- Practice Models for Better Medicine indicating its significant therapeutic poten- cation, Authenticity, Trust, and Common tial, the US Drug Enforcement Agency (DEA) Identity. still classifies cannabis as a Schedule 1 Dr. Lako , who knew Wirthlin, says that drug, lumping it into the same category of those ve items became the central tenets of HolisticEducationExchange.net substances as heroin, LSD, ecstasy, and oth- Reagan’s highly successful campaigns. He ers with “no currently accepted medical won because he embodied a set of spoken as use,” a “high potential for abuse,” and well as unspoken values. Despite being an Learn From the Leaders! “potentially severe psychological or physi- actor—or perhaps because of it—he could cal dependence.” project authenticity and therefore trustwor- The future of cannabis as serious medicine thiness. At the polling places, this mattered Erik Lundquist, MD use will undoubtedly be shaped as much by far more than any stated policy. political forces as by science, the compelling evidence already available, as well as the host Nation as Family, Leader as Parent Bridget Briggs, MD of medical conditions for which mainstream In the course of his work, Dr. Lako began to pharmacology has little to o er, warrants fur- wonder why it is that certain political stances Tom O’Bryan, DC ther research into the therapeutic potential of seem to cluster together. He wondered why this often misunderstood and misrepre- people who are against abortion rights often Jill Carnahan, MD and many more sented plant. support the right to own machine guns? This 14 psyche & soma Fall 2016
feel better,” Dr. Rosenthal stresses. TM also Meditation: A Low-Cost, Low-Risk “Blockbuster” Therapy improves perspective, increases happiness, cant indicators of actual physiological gamma waves (related to attention, con- and helps you get in touch with yourself. By Madiha Saeed, MD changes resulting from regular practice of TM sciousness), and had gamma synchrony.” People who practice meditation regularly Contributing Writer and other meditative disciplines. There are also studies showing that medi- report a feeling of transcendence entering Norman E. Rosenthal, MD, Clinical Pro- tation decreases the brain cell volume of the their waking hours, which helps bring their Many of my patients are skeptical when I rst fessor of Psychiatry at Georgetown Univer- amygdala, which regulates fear, anxiety and bodies back into balance. Regular meditation tell them that something as simple as medita- sity, and a longtime practitioner of TM, stress responses (Holzel BK, et al. Psychiatry helps us make healthier choices, boosts self tion could be their best cure. recently published a book entitled Super Res. 2011; 191(1): 36–43). control, and increases focus, organization, For many people, the word “meditation” Mind, which—among other things—out- While many of the more dramatic brain e ciency and the ability to prioritize tasks. evokes the image of someone in lotus posi- lines the myriad ways that regularly prac- imaging studies have been on experienced Combined, all these processes tend to tion, eyes closed and looking peaceful. It ticed meditation affects neurophysiology. meditators with longstanding and regular enable people to work less and yet accom- seems like something that likely requires a “During TM, there is an increase in levels of meditation practices, there is also evidence to plish more. Mundane activities become less great deal of practice, patience, time, and the soothing hormone prolactin in the blood suggest that just a couple of weeks of regular boring, and it becomes easier to switch e ort. So people put it o . stream. EEG studies show increase in the meditation can help people increase produc- gears. Mindfulness helps people become But the reality is much simpler, and the alpha 1 power in the frontal parts of the brain, tivity by increasing their focus and memory more perceptive and appreciative of the health bene ts are profound. and an increase in alpha coherence in the pre- (Mrazek MD, et al. Psychol Sci. 2013; 24(5): world around them, which leads to an We know that stress is a contributing frontal cortex. There is an increase in blood 776–781). Meditation has also been shown to increase in compassion, social connection cause of roughly 80% of all complaints pre- ow in the prefrontal cortex and elsewhere in help with smoking cessation (Tang YY, et al. and emotional intelligence. senting to us as primary care physicians. A the brain,” Dr. Rosenthal notes. PNAS. 2013; 110(34): 13971–13975). Dr. Rosenthal regularly recommends TM regular practice of mindfulness and working The way meditation changes gray matter Regular meditation has the ability to to his patients, noting that it is e ective and on controlling our minds can combat stress volume is by fostering connections between reduce the risk of heart attack and stroke in easy to learn for anyone over 11 years of age. and help prevent and heal chronic disease. the posterior cingulate, dorsal anterior cingu- people at risk; it increases longevity, decreases He has gathered numerous case studies That’s true for our patients, and for us as late, and dorsolateral prefrontal cortices— atherosclerosis in carotid arteries, increases wherein patients experienced dramatic clinicians. brain regions thought to be involved in sensitivity to circulating insulin, delays left improvements in serious chronic conditions; There have been many studies on the self-monitoring and cognitive control—while ventricular enlargement, reduces frequency seven were able to lower their medication e ect of meditation on the brain and body. A reducing activity in what is termed the and severity of headaches—including use. regular practice has been proven to literally “default-mode network,” a set of brain path- migraines—and attenuates involuntary That said, he is not pushing a view that TM change the brain, lower anxiety, depression ways associated with mind-wandering and movement disorders, such as Parkinson’s and or any form of meditation should be a substi- and pain, improve attention and overall psy- self-referential processing. High levels of Tourette syndrome. tute for medical therapies when needed. chological well-being, and improve heart DMN activity—which typify the waking states Several years ago, the American Heart But physicians should not ignore the health. Meditation also reduces in amma- of most individuals—are strongly correlated Association issued a position statement strong and mounting evidence that medita- tion, which increases the body’s immune with anxiety and unhappiness (Brewer JA, et recognizing TM as a complementary treat- tion positively a ects physiology in many dif- function and decreases pain. al. PNAS. 2011; 108(50): 20254–20259). ment for high blood pressure. AHA also ferent ways. It should have a place in the Many studies have explored the relation- endorsed the practice as a substitute for spectrum of preventive and therapeutic Your Brain on Meditation ship between mindfulness meditation and the certain other medical approaches, depend- modalities that clinicians recommend, and it Meditation changes the brain, literally—the reduction of symptoms of depression, anxiety ing on circumstances. is critical we start to not only relay its impor- whole brain. There are a number of studies (even social anxiety), and pain (Goyal M, et al. As Dr. Rosenthal famously stated, “if Tran- tance to our patients, but to make it a part of showing that certain forms of meditation can JAMA Intern Med. 2014; 174(3): 357–368. scendental Meditation could be put into a our own daily lives. change the entire brain by altering gray mat- Zeidan F, et al. Soc Cog A ect Neurosci. 2014; capsule and marketed like a pharmaceutical, Meditation need not be daunting or di - ter volume, preserving the aging brain, and 9(6): 751–759). it would be a billion dollar blockbuster.” cult. And while many of the meditative disci- increasing neuronal activity in emotional These are not just “subjective” changes. plines available to us today have their roots in areas, frontal areas, and areas related to emo- Referring to a landmark study published in Cultivating the “Super Brain” ancient religious or spiritual communities, tion regulation, self control and positive emo- 2004, Dr. Richard Davidson, director of the He notes that beyond it’s “medical” e ects, meditation itself need not have any religious tions (Luders E, et al. Front Psych. 2015; 5(1)). Waisman Laboratory for Brain Imaging and the regular practice of TM can help people trappings. Transcendental Meditation (TM), a popu- Behavior and founder of the Center for create what he calls the “Super Brain”—a It is really about calming the mind and lar form of meditation training developed Healthy Minds at the University of Wisconsin– brain that is coherent, even tempered, restoring autonomic balance, and it can take and promoted by the Indian teacher Mahari- Madison, notes that “On EEG, long time medi- grounded and calm. This leads to better phys- many forms. Start by going for a walk without shi Mahesh Yogi, has been the subject of a tators—more than 10,000 hours of ical health, enhances life experiences and distractions, or doing a few yoga stretches or number of medical studies. While the ndings practice—their brains are di erent than ones optimizes interpersonal relationships and deep breathing exercises. The most impor- are variable, and it can be di cult to control that don’t meditate. The changes to the brain cognitive functioning. tant thing is to give yourself time to just BE, for bias and subjectivity in studies of modali- structurally, and the changes to the EEG were “Meditation expands mental capacity and without doing anything. Your body and brain ties like meditation, there are many signi - permanent. They were able to self induce one becomes creative, accomplished and you will heartily thank you for it!
tort reforms, estate tax breaks or deregulation to “criminal” is not very big. Any discussion American medicine is largely de ned by Neurobiology of Politics of corporate campaign contributions. Why do about “illegal immigrants” is already biased. Strict Father frames and war metaphors: cont’d from page 13 many of them support leaders and policies The issue could just as accurately be “fighting infections,” “invasive carcinoma,” that don’t serve them? framed as “illegal employment,” putting cul- “therapeutic armamentarium,” “war on can- “market” is supposed to reward self-discipline, “It is because they’re not voting on their inter- pability on the agricultural rms, manufactur- cer,” “barrage of radiation,” “heart attack,” productivity, and intelligence, while punishing ests, they’re voting on their identity,” says Lako , ers, and private citizens who hire immigrants “magic bullet” . . . the list is long. Traditionally, laziness, stupidity, and poor performance. “and that identity was constructed consciously.” for wages far below US norms, to work haz- medicine has been very hierarchical in its By this logic, success and failure are indica- Beginning around 1966, Richard Nixon’s ardous jobs, outside all regulations and pro- organizational structures, with an almost tors of character. Prosperity re ects moral vir- campaign realized there were many working- tections. It would also implicate all of us who military-style chain of command. tue; poverty indicates moral weakness. If people class Americans who identi ed as liberals like cheaply priced goods. That’s why it’s In recent decades the military metaphors are poor, they probably deserve to be, because because the labor movement had raised their never framed that way. have been merged with the language of busi- they lack discipline and ambition or because living standards. At the same time, they held Lako contends American political dis- ness, which de nes practitioners as “provid- they made bad choices. Social and historical “Strict Father” views about family and the course is de ned largely by conservative cog- ers” and ill people as “consumers” that “utilize” factors are secondary, and prosperous citizens military. These were threatened by feminists, nitive frames. resources. Political discussion about health should not be under obligation to help— anti-war protests, and the “counter-culture.” That’s because the conservative move- care is framed around cost and control. It sel- though they may choose to do so via charity. To win that demographic, Nixon ran on ment has invested heavily—to the tune of $4 dom focuses on actual health or care. People with the Nurturing Parent worldview patriotism, anti-communism, and “traditional” billion over the last 35 years—in think tanks, Even when pushing for change, as was the see poverty as symptomatic of societal injustices American values. The campaign belittled femi- leadership institutes, market research rms, case with healthcare reform, progressives not personal moral failings. They believe a nation nists as “bra-burners,” and de ned anyone media strategists, academic chairmanships, argue using frames and metaphors de ned has an obligation to care for its neediest. questioning the Vietnam War as unpatriotic. and ownership of media companies. The by business interests, says Lako . Applied to health care, the Strict Father logic The campaign also coined the idea of the “lib- Republicans, in short, have a very strong cog- What if Democrats had proposed the reform would view a condition like obesity as a character eral elite”—over-educated, cosmopolitan nitive strategy that reinforces Strict Father plan as “The American Families Plan” or “Patriot- aw—a lack of self-control. A Nurturing Parent people who’d never worked an honest day and frames, and dismisses the Nurturing Parent Care,” rather than the “A ordable Care Act”? view sees it as the result of genetic predisposi- who look down on working people. model with terms like “Nanny State” and “The Democrats are not saying what is true. tion—beyond a person’s control—driven by It was a deliberate attempt to break the “Meddling Government.” They’re giving policy lists. What they’re not say- social forces like lack of education, price dispari- working class identi cation with the political Democrats and progressives, Lako says, ing is, the insurance industry health care is failing ties between junk and healthy food, relentless left. For the most part, says Lako , it worked. have not made nearly the same investment. us! Insurance companies deny care because of ads that promote over-consumption. Many still hold a Cartesian version of rea- the pro t motive. The reason it is so expensive is How you feel about an issue like universal Manufacturing Mindsets son—think Al Gore in the 2000 election. Fur- because one-third of the money goes to admin- health care will depend on whether you Projection of values is contingent on crafting ther, American liberals view any intentional istrative costs and pro t to the investors.” unconsciously view illness as the “just” conse- and disseminating speci c language frames. cognitive framing as “spin” or “propaganda,” Health care, says Lako , is a moral issue. It quence of moral weakness, or the result of Are those armed men “freedom ghters” or all of which they nd abhorrent. involves matters of life and death. But policy factors largely beyond a person’s control. “terrorists”? Is that beggar “downtrodden” or The net result is that even when they language doesn’t focus on that. “They’re not The reason issues like environmental regula- “lazy”? That scientist, is she projecting “exper- win—as has been the case with the Obama saying, ‘Have you ever had to wait for weeks tion, taxation, worker’s rights, and tort law tise” or “elitism”? “Open-minded” or “wishy- administration—the Democrats must try to for an authorization? Or lost your HC bene ts bother many conservatives is because they washy”? “Outspoken” or “domineering”? lead within a cultural and cognitive land- because you lost your job?’ They don’t say it, challenge the fundamental paternal authority “Peaceful protester” or “angry militant”? scape curated and cultivated by their alleged but they should.” of “the market” and the people who run it. Liber- The same phenomenon can be framed in political opponents. On any political issue, the cognitive frames als with a Nurturing Parent ideal want to chal- di erent ways, says Lako . shape the outcomes. This is why Lakoff lenge that authority, so they support these. Consider immigration. The issue is typically Frames & Metaphors in Health Care believes it is essential for citizens to become framed around the idea of “illegal aliens.” This That’s not to say there is no framing and re- more aware of and re ective about the lan- Self Interest vs. Self Identity directs moral condemnation toward the immi- framing coming from the political left. Much guage used by politicians and media gures. Working people struggling to make ends grants, most of whom are simply seeking hon- of the debate around “political correctness” It is only by understanding one’s own meet do not bene t from things like lax envi- est work and the chance to improve their lives. comes from a conservative reaction to left- unconscious frames, metaphors and narratives ronmental rules, the breaking of labor unions, But the cognitive leap from “illegal” immigrant wing language challenges. that one can truly vote one’s conscience. hcp-gi-hcp-vFINAL.pdf 1 7/14/16 2:43 PM
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