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Top Docs Urge Obama toward "Integrative" Medicine

Famed physicians co-sign an essay advocating for lifestyle-based
prevention and natural remedies; US survey shows unconventional
healthcare remains popular
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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):
- "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."
- "... 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."
- "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.imakenews.com/eletra/go.cfm?z=vitalchoiceseafood%2C330255%2Cb1kJkvww%2C2924730%2Cbf0n8N4