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Top Docs Urge Obama toward “Integrative” Medicine
1/13/2009
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Famed physicians co-sign an essay advocating for lifestyle-based prevention and natural remedies; US survey shows unconventional healthcare remains popular

The Obama administration-in-waiting is being swamped by a flood of suggestions.

We hope that he acts on some very good ideas published last week in
The Wall Street Journal by four of America’s leading medical thinkers and researchers: Dean Ornish, MD, Andrew Weil, MD, Deepak Chopra, MD, and Rustum Roy, PhD.

Their main point is that to bring down rates of major diseases... and the need for costly interventions... any effective overhaul of the healthcare system must tackle the preventable causes of America's major diseases.

They want Mr. Obama’s administration to advocate and support lifestyle changes — diet and exercise — proven to prevent common, chronic conditions.

And they want any healthcare reform law to require coverage of 
all proven-effective preventive and therapeutic approaches, whether conventional or “alternative”.

In essence, they advocate for an approach called
integrative medicine, which combines conventional medicine with “complementary and alternative medicine” (CAM).

CAM is an umbrella term that encompasses such “unconventional” approaches as vitamins, nutraceuticals, herbs, acupuncture, homeopathy, chiropractic, yoga, exercise, mind-body techniques, and more.

In support of their position, these well-known practitioners cite the ineffectiveness of many major, costly therapies for treating heart disease, and the proven efficacy of much cheaper and simpler preventive measures, including nutrition, exercise, and stress-relieving practices.

The authors all combine high public profiles with the respect of their peers:
  • Dean Ornish, MD, is clinical professor of medicine at the University of California and creator of the famed Ornish lifestyle plan, proven to reverse cardiovascular disease.
  • Andrew Weil, MD, is director of the University of Arizona Center for Integrative Medicine and the author of several bestsellers about integrative, natural, and anti-aging medicine.
  • Deepak Chopra, MD, is guest faculty at Beth Israel Hospital/Harvard Medical School and the author of more than 50 books on mind-body-spirit connections.
  • Rustum Roy, PhD, is professor emeritus of materials science at Pennsylvania State University.
Doctors’ essay gets to the heart of healthcare reform
The essay published in last Friday’s edition of
The Wall Street Journal made three key points (Chopra D et al. 2008):
  1. “Integrative medicine approaches such as plant-based diets, yoga, meditation and psychosocial support may stop or even reverse the progression of coronary heart disease, diabetes, hypertension, prostate cancer, obesity, hypercholesterolemia and other chronic conditions.”
  2. “… if we want to make affordable healthcare available to the 45 million Americans who do not have health insurance, then we need to… provide incentives for healthy ways of living rather than reimbursing only drugs and surgery.”
  3. “Integrative medicine approaches… are both medically effective and, important in our current economic climate, cost effective… Mr. Obama should make them an integral part of his health plan...”
Their second point was reinforced by the results of the US survey described below, which found that people worried about the cost or delayed receipt of conventional care were “…more likely to use complementary and alternative medicine (CAM) than when the cost of conventional care was not a worry” (NIH 2008).

As the four essayists wrote, the promise of dietary changes is powerful: “A recent study… found that these approaches may even change gene expression in hundreds of genes in only a few months. Genes associated with cancer, heart disease and inflammation were down-regulated or ‘turned off’ whereas protective genes were up-regulated or ‘turned on.’”

This passage referred to a small pilot study co-authored by Dr. Ornish and published in the
Proceedings of the National Academy of Sciences (Ornish D et al. 2008).

This study involved 30 men with low-risk prostate cancer who volunteered for a three-day intensive residential retreat, followed by an outpatient phase during which participants spoke with a study nurse weekly by phone. To control their diets, the participants were provided with all of their food during the study period.

The lifestyle modifications included these key measures:

Diet, exercise, and stress management
  • A whole foods, plant-based, low-fat diet (10% of calories from fat).
  • Stress management – 60 minutes per day (stretching, breathing, meditation, imagery, and progressive relaxation).
  • Moderate aerobic exercise (walking 30 minutes per day, six days per week)
  • One-hour group support session per week.
Daily Supplements
  • Fish oil – 3 grams (3,000 mg)
  • Vitamin E – 100 IU
  • Selenium – 200 mg
  • Vitamin C – 2 grams / 2,000 mg
  • One serving of tofu plus 58 grams (2 oz) of a soy protein beverage
As Dr. Ornish wrote last June in Newsweek, “We found that many disease-promoting genes (including those associated with cancer, heart disease, and inflammation) were down-regulated or ‘turned off,’ whereas protective, disease-preventing genes were up-regulated or ‘turned on.’ …These genes are the target of many new drugs that are being developed. Clearly, changing lifestyle is less expensive, and the only side-effects are good ones” (Ornish D 2008).

Official US survey shows Americans turning to alternatives
Coincidentally, the latest survey of use of alternative medicine among Americans was released last month.

This report used data from the 2007 National Health Interview Survey (NHIS), conducted by the Centers for Disease Control and Prevention, while trends were assessed by comparing data from the 2007 and 2002 NHIS.

The survey report — titled
Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007 — found that more than one-third of adults and nearly 12 percent of children in the United States use alternatives to traditional medicine (Barnes PM et al. 2008).

And it shows how common acupuncture, herbal remedies, and other once-exotic healthcare approaches have become:
  • Almost 4 out of 10 adults (38%) had used CAM therapy in the past 12 months.
  • The most commonly used therapies were non-vitamin, non-mineral natural products such as herbs and “nutraceuticals” — such as antioxidants, gingko, and fish oil (17.7%) — and deep breathing exercises (12.7%).
  • About one in nine children (11.8%) used CAM therapy in the past 12 months, with the most commonly used therapies being non-vitamin, non-mineral, natural products (3.9%) and chiropractic or osteopathic manipulation (2.8%).
  • People were more likely to use CAM when they were worried about the cost of conventional care or delayed receipt of that care.
  • Between 2002 and 2007 increased use was seen among adults for acupuncture, deep breathing exercises, massage therapy, meditation, naturopathy, and yoga.
The survey found that use of complementary and alternative healthcare approaches has held steady among adults since the last national survey in 2002, and that these approaches have become a routine part of healthcare for many children.


Sources
  • Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. National health statistics reports; no 12. Hyattsville, MD: National Center for Health Statistics. 2008.
  • Chopra, D, Ornish D, Weil A, Rustum R. “Alternative” Medicine Is Mainstream. Wall Street Journal (WSJ). Jaunary 9, 2009. Accessed online at www.djreprints.com.
  • Ornish D, Magbanua MJ, Weidner G, Weinberg V, Kemp C, Green C, Mattie MD, Marlin R, Simko J, Shinohara K, Haqq CM, Carroll PR. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proc Natl Acad Sci U S A. 2008 Jun 17;105(24):8369-74. Epub 2008 Jun 16.
  • Ornish D. Changing Your Lifestyle Can Change Your Genes. Newsweek, June 17, 2008. Accessed online at http://www.newsweek.com/id/141984

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