The Proceedings From the 13th International Symposium of The Institute for Functional Medicine Managing Biotransformation: The Metabolic, Genomic, and Detoxification Balance Points This activity is jointly sponsored by the Institute of Functional Medicine along with Alternative Therapies in Health and Medicine and InnoVision Health Media HEALTH MEDIA INC. Supplement to Alternative Therapies in Health and Medicine Inside The Proceedings From the 13th International Symposium of The Institute for Functional Medicine Managing Biotransformation: The Metabolic, Genomic, and Detoxification Balance Points Presentation Articles Include: Managing Biotransformation: Introduction and Overview................................................................S 85 by Jeffrey Bland, PhD Who Ignores Individuality Fails the Patient........................................................................................S 88 by Sidney Baker, MD Detoxification Basics .............................................................................................................................S 96 by Elizabeth Jeffery, PhD Diet and Detoxification Enzymes ..........................................................................................................S 98 by Elizabeth Jeffery, PhD Working Up the Toxic Patient: Practical Interventions and Treatment Strategies .....................S 100 by Peter Bennett, ND Diet, Genetic Polymorphisms, Detoxification, and Health Risks................................................... S 108 by Johanna Lampe, PhD, RD Xenoestrogens, Biotransformation, and Differential Risks for Breast Cancer..............................S 112 by Eleanor Rogan, PhD Chemo Protection Against Cancer: An Idea Whose Time Has Come..........................................S 122 by Albena T. Dinkova-Kostova, PhD The Role of Mercury and Cadmium Heavy Metals in Vascular Disease, Hypertension, Coronary Heart Disease, and Myocardial Infarction ..............................................S 128 by Mark Houston, MD Systems Biology,Toxins, Obesity, and Functional Medicine.............................................................S 134 by Mark Hyman, MD Children’s Cognitive Health:The Influence of Environmental Chemical Exposures....................S 140 by David Bellinger, PhD Molds and Mycotoxins: Beyond Allergies and Asthma ....................................................................S 143 by Michael Gray, MD Components of Practical Clinical Detox Programs—Sauna as a Therapeutic Tool.....................S 154 by Walter Crinnion, ND About the Institute for Functional Medicine: IFM’s mission is to serve the highest expression of individual health through • Our innovative and visionary leadership, model for personalized patient care, widespread adoption of functional medicine as the standard of care. and commitment to quality drive our success. • Functional medicine is patient-centered health care that addresses the unique • We commit time, energy, and resources to insure that those we touch feel interactions among genetic, environmental, and lifestyle factors influencing great value from their experience with us. both health and complex, chronic disease. Managing Biotransformation: The Metabolic, Genomic, and Detoxification Balance Points S 81 13th International Symposium of The Institute for Functional Medicine Welcome he 2005 Clemens and Pressman article titled “Detoxification Diets Provide Empty Promises”1 prompted considerable discussion at the Institute for Functional Medicine (IFM). The daily clinical experiences of our faculty and our practitioner base, and the evidence with which we were familiar at 4411 Pt. Fosdick Drive NW, Suite 305 the time, directly challenged the article’s conclusion that, “These approach- P.O. Box 1697 • Gig Harbor,WA 98335 Ph: 800-228-0622 • Fax: 253-853-6766 es are contrary to scientific consensus and medical evidence and are not consistent with Web: www.functionalmedicine.org Tthe principle that diets should reflect balance, moderation and variety.” As Dr. Jeffrey Bland points out in his introduction to this Proceedings for the 13th International David S. Jones, MD, President, Director of Medical Education Sheila Quinn, Senior Editor and Special Projects Symposium: “While the principles of balance, moderation, and variety are excellent guide- lines for constructing public health policies, they may not be specific enough for con- structing the proper diet for a patient with a specific alteration in his or her functional capacity for detoxification.” HEALTH MEDIA INC. The Institute decided to investigate further. We devoted more than 6 months to 2995 WIlderness Place, Suite 205 • Boulder, CO 80301 the discovery process for this symposium, reviewing research and discussing the topic Ph: 303.440.7402 • Fax: 303.440.7446 with experts in the field. We found a valuable and growing evidence base, developed by Web: www.innerdoorway.com both researchers and eminent clinicians, that paints a very rich picture of significant Executive VP And Group Publisher interconnections between diet and the processes of biotransformation and detoxifica- Rob Lutz tion. Within the presentations from the faculty we assembled for this symposium, you will find robust research and clinical evidence demonstrating the importance of match- VP,Content Development ing the patient’s unique genomic characteristics to the appropriate diet, food prepara- Frank J. Lampe tion, and eating patterns in order to induce the appropriate phase I and phase II Associate Publisher enzymes responsible for balanced detoxification of exogenous molecules and biotrans- Randy Goldner formation of endogenous metabolic by-products. The faculty brought to this symposium much that is practical and ready for clinical Associate Publisher Katy Kinsella application—for example, the exciting research from the emerging field of chemoprotec- tion that provides dietary strategies for defense against carcinogenesis. You will also learn Account Executive about the profound effects of, and possible solutions for, exposure to heavy metals (such Scott Blackburn as mercury) and other organic and inorganic toxicants that can produce adverse effects, Publishing Project Manager including oxidative stress, inflammation, thrombosis, vascular smooth-muscle dysfunc- Sharon M. Kupchin tion, dyslipidemia, and mitochondrial dysfunction. The specter of obesity, an epidemic today in the industrialized world, emerges from these pages in a cause-effect relationship Circulation Director with environmental toxins. Toxins can increase oxidative stress, affecting redox signaling, Nick Collatos which, in turn, influences gene transcription and signaling pathways controlling insulin Subscriptions κ resistance, cytokine modulation, and mitochondrial function. Activation of NF B (a gene Innovision Health Media Publications transcription factor) is mediated by redox balance and is a final common pathway for PO Box 231655, Encinitas, CA 92023 obesity and many other chronic illnesses. These actions and reactions contribute to the Phone: 760.633.3910 • Fax: 760.633.3 Subscribe online: www.alternative-therapies.com epidemic of weight gain and resistance to weight loss. Evidence from years of both bench science and clinical research by the sympo- sium’s distinguished faculty demonstrates a very real and important connection Editor-In-Chief, between the specificity of patients’ genetic/environmental uniqueness and their health Alternative Therapies in Health and Medicine Mark Hyman, MD status. These presentations substantiate a position that detoxification diets can help ful- fill the promise that a carefully crafted, personalized, dietary and lifestyle plan will create Editor, IFM Proceedings significant health benefits for our patients. Working closely with our partner in this pro- Sheila Quinn ject, InnoVision Health Media, the Institute for Functional Medicine (www.func- Managing Editors tionalmedicine.org) proudly brings you this Proceedings from the 13th International Lisa Anne Marshall, Suzanne Snyder Symposium on Functional Medicine. Creative Director Lee Dixson Editorial Assistant Darren Villeneuve President and Director of Medical Education The Institute for Functional Medicine (IFM) All rights reserved. Reproduction in whole or in part without specific written permission from Alternative Therapies in Health and Medicine is prohibited by law. References: 1. Clemens R, Pressman P. Detox diets provide empty promises. Food, Medicine, & Health. 2005; 59(5):18. S 82 Managing Biotransformation: The Metabolic, Genomic, and Detoxification Balance Points 13th International Symposium of Introduction The Institute for Functional Medicine Managing Biotransformation: Introduction and Overview Jeffrey Bland, PhD, FACN Jeffrey S. Bland, PhD, is an educator, research professor, leader in kinds of diseases and adverse effects.7 For example, exposure to specific the natural products industry, and expert in human nutrition and toxins and the absence of proper support for detoxification functions functional medicine who serves as chief science officer of are both thought to increase the risk for neurodegenerative conditions Metagenics, Inc., in Gig Harbor, Wash. Dr Bland is the founder of, such as Parkinson’s disease,8,9 and in both situations genetic variability and serves as the founding board chair for, the Institute for is common. It is well known that individuals who consume a poor-qual- Functional Medicine. ity diet and/or excess alcohol—and concomitantly take aceta- minophen—have a much-higher risk