Integrative Health Care Symposium 2011

Report on Integrative Health Symposium-, NY, NY March 4-6, 2011 Filed by Rosalie Yelen

This year, the conference covered five key areas: Nutrition, Integrative Oncology, Endocrinology, Brain and Mind Health and Leadership and Policy.

The following is a summary of selective keynotes, workshops, and panel discussions which were relevant to cancer prevention and treatment.

Keynotes:

David Perlmutter, MD : “Epigenetic Modulation of the Brain”

Dr. Perlmutter is a board-certified neurologist, Fellow of the American College of Nutrition, and the author of several books and publications in leading medical journals. He has appeared on numerous television talk shows, and has received awards for his innovative approaches to neurological disorders.

According to Dr. Perlmutter, inflammation and oxidation are present in virtually all degenerative diseases. To correctly diagnose, one needs to look for what is activating the microglia cells in the brain. Regarding treatment, Dr. Perlmutter believes that drugs are for symptoms, and that we need to treat inflammation to get to the underlying disease. He stated that all cell phones “fry brains”, as witnessed in Alzheimer’s patients. His preferred treatment approach includes vitamin D, which he believes is a powerful protector of the brain against infection, and also can protect against Alzheimer’s disease.

Dr. Perlmutter cited a study from India which found that turmeric/curcumin intake correlated with the lowest incidence of Alzheimer’s disease. He also uses broccoli, broccoli sprouts, garlic, DHA, green tea extract, and glutathione to prevent and treat diseases of the brain. He stressed the importance of healthy oils such as coconut, in prevention and treatment. Dr. Perlmutter stated that meditation and prayer positively affect the limbic system as well, by reducing fear-based reactions.

Alan Gaby, MD : “Controversies in Nutrition.”

Dr. Gaby was a private practice physician for seventeen years, specializing in nutritional medicine. He is past president of the American Holistic Medical Association and has given expert testimony to the White House Commission on Complementary and Alternative Medicine. The author of numerous scientific papers in the field of nutritional medicine, Dr. Gaby has recently completed a textbook of nutritional medicine.

Dr. Gaby’s first discussed the controversy around calcium supplementation and heart disease. He stated that all the studies linking calcium supplementation to heart disease conducted thus far have been problematic. He stressed that calcium must always be combined with magnesium for heart disease prevention. The doctor stated that a good ratio of calcium to magnesium is 800/400.

Dr. Gaby then discussed the safety of hi-dose vitamin D. He stated that 800-1200 IU is generally an effective intake, although the body can tolerate 4,000-10, 00 IU/day, which he prescribes for persons with chronic disease. Optimal vitamin D blood levels, according to the doctor, are 36-40 ng/ml. Dr. Gaby believes that the serum 25 ()H) test is not always a reliable indicator of vitamin D levels, since it is only one of fifty vitamin D metabolites in the bloodstream. He said that variables to consider include recent intake of vitamin D, recent sun exposure, etc. In conclusion, he stated that the long term safety of more than 2,000-4,000 IU/day for the average person is weak.

Dr. Gaby’s next topic was the safely of megadose iodine.

He stated that does of 700-4500 mg can cause thyroid dysfunction. He cited a New Eng. J of Medicine study that found higher thyroid disease with doses higher than 500 mg/day. Dr Gaby recommends 3-6 mg/day as a preventative to treat patients with breast cysts and to improve patients’ estrogen metabolism. The doctor cautions against using iodine for hypothyroidism. Regarding the use of high dose strontium for osteoporosis, he stated that strontium has been proven to prevent fractures, but there is no certainty regarding the safety of the supplement at high doses. His current speculation is that 6mg/day is safe. He also stated that a higher dose could be safely used for 1-3 years and then lowered as an alternative to bisphosphonates.

Tieraona Low Dog, MD: The Relationship of Environment and Human Health: Enhancing Awareness.”

Dr. Low Dog is the Fellowship Director at the Arizona Center of Integrative Medicine at the University of Arizona. She is an internationally recognized expert in the field of herbal medicine and women’s health who has authored/edited five books, and serves on numerous advisory and editorial boards. Dr. Low Dog was appointed by President Clinton to the White House Commission on Complementary and Alternative Medicine Policy, and served on the advisory council for the National Institutes of Health National Center for Complementary and Alternative Medicine.

According to Dr. Low Dog, there is an intricate web connecting our external environment and our internal environment. What we eat, drink, breathe, and put on our skin affects our nervous system, immune system, reproductive system, cardiovascular system and digestive system.

Dr Low Dog maintains that beginning in the womb; our bodies are bombarded with environmental toxins that impact our bodies in different ways. Citing a 2005 study of newborns conducted by the Environmental Working Group, she stated that 287 chemicals had been found in umbilical cord blood samples of newborns. Many of these chemicals have known toxicity to the brain and nervous system and also cause birth defects or abnormal development in animal tests.

The doctor stated that there is a demonstrated association between exposure to neurotoxins (mostly from pesticides) and ADHD-like behavior. Phthalates, (plasticizers), another group of chemicals ubiquitous in our environment, have been found to be potent endocrine disruptors, producing adverse reproductive effects. Thousands of phthalate-containing chemicals have been banned from European cosmetics, whereas the U.S. FDA has banned or restricted only 11.

Dr. Low Dog also discussed the impact on the digestive system of various allergens, toxins, and pathogens in the environment. These have been attributable to leaky gut, as well as neurodevelopmental and neurodegenerative disorders. High levels of bovine growth hormone from dairy and meat and dioxin-like compounds from dairy, meat and fish have been linked to increased risk of breast cancer.

Dr Low Dog noted that some progress in several manufacturers’ response to public concern and pressure to remove harmful chemicals from their products; however, as previously mentioned, according to the doctor, the U.S. government has been very slow to act to protect consumers from environmental toxins and dangerous chemicals.

Jeffrey Bland, PhD: “The End of the Term ‘Disease’ and the Future of Medicine.”

Dr. Bland is Metagenics’s Chief Science Officer, and President of Metaproteomics. He has been an internationally recognized leader in nutritional medicine for over 25 years. Dr. Bland established the internationally respected Institute for Functional Medicine to train health practitioners in the application of nutritional and functional medicine. He is the principal author of over one hundred peer-reviewed research papers on nutritional biochemistry and has also authored nine books on nutrition and health and nutritional medicine.

In his presentation, Dr. Bland explored the history of medicine and the impact of various other related disciplines in order to provide an understanding of where he believes that medicine is headed, how it will be delivered and by whom.

Dr. Bland discussed the evolution of medical thought from classifying illness as disease to present day classification of illness as functional somatic syndromes or “dysfunction.”, and the focus shift from cookie-cutter type disease treatment to treatment of the individual and the disease.

Dr. Bland, like the other conference presenters, believes that the origin of syndromes, dysfunction and disease is related to the interaction of an individual’s genes and the environment. Epigenetic changes, (changes in gene expression which are caused by mechanisms other than changes in the underlying DNA), he believes, are related to all chronic diseases.

As an example, he cited a N Eng J Med article from 2010 which found that a mutated DNA methyltranserase was found to be associated with leukemia. In discussing the role of the environment as a causative factor of many diseases, Dr. Bland pointed to the significant correlation between elevated serum levels of persistent organic polluters (POPS) and diabetes, obesity and heart disease.

Dr. Bland went on to discuss about the relationship between food and nutrition and how they can affect glucose regulation. He refers to the development of an optimal diet as “genomic nutrition.” He cited studies that found certain foods and nutrient to be protective against chronic disease by modulation genetic expression.

Dr. Bland also discussed the concept of “hormesis”- how small amounts of some substances- nutrients or foreign substances- can have a much larger influence on cellular function than would be anticipated. He maintained that functional medicine is moving away from phytonutrition to phytopharmacology and the use of multiple agents and modalities to modulate organ functions. This regulating of function, rather than treating disease symptoms, is establishing a new paradigm.

Dr B. concluded by stating that medical education in primary care is headed towards developing expertise in a systems biology approach to chronic illness¸ or what has become known as functional medicine.

Mark Hyman, MD “Diabesity: A Functional Medicine Approach to the Underlying Causes of Obesity and Diabetes.”

Dr. Hyman is a family physician, a Functional Medicine practitioner, and a best-selling author. He is founder and Medical Director of the Ultra Wellness Center in Lenox. Ma, chair of the board of the Institute for Functional Medicine, board member of the Center for Mind-Body Medicine, and a nominee to President Obama’s Advisory group on Prevention, Health Promotion and Integrative and Public Health.

Dr. Hyman defined obesity as a system disorder characterized by metabolic imbalances ranging from mild insulin resistance to end-state diabetes, which affects over one billion people worldwide. He believes the underlying causes of this epidemic to be diet, sedentary lifestyle and chronic stress. Dr. Hyman maintains that the current mainstream medicine practice of treating insulin resistance and diabetes with insulin causes negative side effects, particularly heart attacks.

Dr. Hyman sees inflammation caused by sugar overload, bad fats, and allergens as the main underlying factor with diabesity, what he calls “the condition of metabolic imbalances ranging from mild insulin resistance to end-state diabetes. “ His treatment protocol includes addressing clinical, nutrient, and hormonal imbalances, and most of all, determining and treatment sources of inflammation in the body.

As part of his systems approach to obesity, Dr. Hyman places much emphasis on digestive imbalances and gut dysfunction. He believes that food allergy, especially gluten intolerance, and weight gain are an unrecognized epidemic. He also believes that insulin resistance may actually cause food allergy.

Like many of the other presenters, Dr. Hyman believes that toxins are causative underlying factors in disease formation. He also believes in toxin mediated obesity and the need for detoxification treatment. He stated that the oxidative stress from thyroid problems, toxins, infection, etc., lead to mitochondrial dysfunction which in turn leads to diabesity. In his practice, he treats oxidative stress with a combination of whole foods, a high nutrient, low glycemic diet, stress reducing foods (i.e. wild fish, fiber, green leafy vegetables, whole grains, etc) and stress reducing supplements. He also emphasized the importance of regular exercise and stress reduction.

Environmental Oncology Panel:

“The Environment and Cancer: Observations from the Field.”

Devra Davis, PhD, Susan Luck RN, BS, MS, HNC, CCN, Mitchell Gaynor, MD

Dr. Davis is President of Environmental Health Trust. She is the author of three books and over 190 publications. She has served on the Chemical Safety and Hazard Investigation Board under Pres. Clinton,as well as the Intergovernmental Panel on Climate Change, and as the Senior Advisor to the Assistant Secretary for Health.

Dr. Davis’ discussion centered around the dangers of cell phones. She pointed out that cell phones use the same frequency as microwave ovens. She also stated that 50 minutes on cell phones elevates glucose levels in the brain. Dr. Davis cited a JAMA study which found that cell phones disrupt DNA through accelerated cell growth. The impact of cell phones, she stated, is even worse for children. Distance from the head is protective; therefore a headset will reduce exposure somewhat.

Her website: www.environmentalhealthtrust.org

Susan Luck has worked in the field of nutrition and immunology for over 25 years. She a pioneer in holistic nursing education and is the director of the Integrative Nursing Institute. She is the founder of the Earthrose Institute, an organization dedicated to educating individuals, health care providers, and communities on the environment and women and children’s health. Ms Luck is currently adjunct faculty at the University of Miami and Clinical Nutritionist at Mercy Hospital in Miami, Fla, as well as maintaining a private practice in Nutrition and Wellness Coaching.

Susan Luck focused on the connection between pesticides and cancer. She noted that atrazine is the major culprit in the brain cancer cluster in agricultural areas in Florida. The pesticide is banned in some European countries. She also stated that benzene on military bases is causing testicular and brain cancer in men.

Ms. Luck has been educating not- for- profits and health care workers on the dangers of xenoestrogens and hormone disruptors. She strongly emphasized the importance of getting practitioners to conduct environmental assessments on their patients to determine the antecedents of their illness.

Dr. Gaynor is Founder and President of Gaynor Integrative Oncology, Assistant Attending Physician at NY Presbyterian Hospital/Weill Cornell Medical Center, and Assistant Professor of Medicine at Weill Medical College. He is also former Medical Director and Director of Medical Oncology at the Weill Cornell Medical Center Institute. Dr. Gaynor is the author of four books and a CD focusing on healing, health and the environment and cancer prevention.

Dr. Gaynor’s discussion focused on epigenetics and prevention of disease. He stressed the importance of detoxifying enzymes and antioxidant such as turmeric, resveratrol, raspberries and black raspberry powder. Dr. Gaynor cautioned against consuming high mercury fish, eating skin of turkey and chicken, and using microwaves and cordless phones. He advised lowering IGF levels (the strongest tumor promoters) through the use of metformin and urged the consumption of broccoli seeds, broccoli extract and probiotics on a regular basis.

Workshop: Mitchell Gaynor, MD: “Biomarkers for Cancer Prevention and Treatment.”

See biography above.

Biomarkers, as Dr. Gaynor explained, are the chemical blueprints for fighting cancer. They are the detectable changes in the body that convey information about disease state, susceptibility, or exposure.

Examples are hemoglobin expression as markers of red blood cells, and HIV antibodies as markers of HIV infection. There are predictive biomarkers which identify who is likely to benefit from a particular treatment (e.g. Oncotype Dx), and prognostic biomarkers, which are measured before a particular treatment is chosen to determine long-term outcome for patients untreated or receiving standard treatment. Like many of the other conference presenters, Dr. Gaynor’s approach is based on the principles of environmental ecology and epigenetics.

Dr. Gaynor stated that in terms of breast cancer prediction, there have been almost 1,000 articles on prognostic markers or factors in the last 20 years. Typically, however, only routine testing for ER, PR and HER-2 has been recommended.

Dr. Gaynor discussed the practice of ductal lavage, as a very early biomarker test which he believes makes a good deal of sense. This procedure, which analyzes nipple aspirate fluid for cytology and environmental carcinogens, is being studied by a consortium of medical institutions.

Dr. Gaynor favors targeted nutritional approaches as a key component of his treatment protocol. He stated that integrative medicine has the ability to alter gene expression with nutrients in food and nutritional supplements. Examples given were resveratrol’s ability to affect apoptosis, grapeseed extract’s ability to affect hormone regulation, and detoxifying enzymes as the first line of defense against environmental toxins.

Regarding detoxifying enzymes and breast cancer, Dr. Gaynor asserted that women with the lowest levels of GST (glutathione-S-transferase) were found to have a fourfold risk of breast cancer. Dr Gaynor also discussed vitamin D and breast cancer, stating that the vitamin may play a key role in immune system activation, and deficiency has been linked to poorer outcomes. He also cited a 2009 JAMA study which found that dietary soy was protective against breast cancer for both survivors and women at risk.

Dr. Gaynor devoted a substantial portion of his presentation to ovarian cancer diagnosis and treatment. He discussed the concept of exosomes, ways in which cells communicate with one another directly or by transferring molecules between cells. He stated that micro RNA profiling of circulating tumor exosomes and circulating tumor cells could be used as diagnostic markers for ovarian cancer.

He also favors using the HE4 scan in conjunction with CA125, rather than CA 125 alone. Dr. Gaynor stressed that obesity is associated with both shorter time between recurrence and shorter overall survival in women with ovarian cancer. He maintained that all women should have yearly routine transvaginal sonograms to test for ovarian cancer.



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