Fact: There are several factors involved in metabolism that affect one’s weight that go beyond calories consumed vs calories expended. People differ in their genetic makeup and different genes can affect metabolism as well as how one responds to different foods. There are fields of science which document food-gene interactions and follow under the categories of foodomics and nutrigenetics. Additional factors include hormone balance, certain medications, medical conditions including sleep apnea, and other factors.
Fact: According to America’s Health Rankings, in partnership with the American Public Health Association, the US is now at its highest rates of chronic conditions and premature death since being analyzed in the past 34 years. The following chronic conditions reached their highest levels:
Arthritis
Asthma
Cancer
Cardiovascular Diseases
Chronic Obstructive Pulmonary Disease (COPD)
Chronic Kidney Disease
Depression
Diabetes
Fact: A 2023 paper reported a survey of United States medical students that found the following:
An average of 1.2 hours of formal nutrition education per year was reported across all participants. This totals 6 hours in 5 years. In contrast, Naturopathic Doctors receive approximately 155 classroom hours of training in nutrition and additional training in clinical internship.
93.4% of students either somewhat or strongly agreed that understanding the effects of nutrition/eating decisions on the human body is critical to maximizing patient care.
Fact: According to the National Cancer Institute: ”Up to 10% of all cancers may be caused by inherited genetic changes.” Damaged genes occur during a lifetime from environmental toxins and an unhealthy diet. This means that people can be proactive in preventing cancer.
The following chart from the American Institute for Cancer Research describes cancer-fighting phytochemicals.
Fact: LDL cholesterol (LDL-C) is one factor out of many when it comes to heart disease risk. Consider a recent study in the mainstream BMJ Open with the title: Is LDL cholesterol associated with long-term mortality among primary prevention adults? This study analyzed data in adults (aged 50-89) who were generally healthy and without diabetes and not on statin therapy and all-cause mortality (death). Approximately 180,000 patients with a mean age of 61 and a mean LDL-C of 119 mg/dL were evaluated over 6.1 years. Interestingly, the authors found that the lowest risk for long-term mortality was in those with an LDL-C range of 100-189 mg/dL. In their introduction, the authors stated”: “Despite the generally accepted belief that ‘lower LDL-C is better,’ meta-analyses indicate that high LDL-C is associated with at most a small increased absolute risk of ASCVD or premature mortality.”
Fact: Up until recently, much of conventional medicine attempted to discredit the ancient notion of gut health imbalance and its association with digestive and non-digestive illness. As modern scientific research has proven, ancient healers and today’s integrative doctors were correct on this matter. For example, Harvard Health Publishing recently published an article recognizing the legitimacy of leaky gut and noted that most doctors would not recognize the term.
Also, an article in the mainstream medical journal Frontiers in Immunology states. "Disruption of the epithelial barrier increases intestinal permeability, resulting in leaky gut syndrome (LGS)." The epithelial layer refers to the cells that line the small intestine.
Now medical researchers and gastroenterologists at the forefront of gut permeability research have done a complete turnaround and acknowledge the medical reality of "leaky gut." Simply put, leaky gut (increased intestinal permeability) occurs when the small intestine lining is damaged by a variety of factors (diet, stress, medications, toxins, infections, and others). As a result, there is increased permeability to substances that should not penetrate the intestinal barrier and two things happen. First there is an immune and inflammatory reaction in the intestinal cells which causes localized damage. And second, molecules that should not be absorbed through the gut wall make their way into the bloodstream. The immune system reacts with an inflammatory response which can then affect other areas of the body in an adverse fashion. In accordance with what I am claiming, the Journal of the Endocrine Society reports:
Intestinal barrier function is critical for normal homeostasis of the gut, and the breakdown or dysfunction of this barrier is associated with local as well as systemic consequences largely related to direct contact of bacteria/bacterial products with the epithelial cells, and translocation of these to the systemic circulation.
Many experts agree that leaky gut occurs in conditions such as inflammatory bowel disease (e.g., Crohn's disease), irritable bowel syndrome (IBS), and celiac disease. However, research also shows that leaky gut increases in various diseases such as diabetes, chronic kidney disease, cancer, and cardiovascular diseases. Moreover, recent research has shown that a leaky gut is a common occurrence with aging.
Fact: There are severe nutritional supplements which have demonstrated powerful blood sugar lowering effects. One example is berberine, a natural compound with a long history of use in herbal therapy to reduce glucose and insulin levels. It is found in plants such as barberry, Oregon grape, tree turmeric, and others.
Some exciting studies have been done comparing the effectiveness of berberine to that of Metformin for people with Type 2 diabetes.
Study 1
80 people with Type 2 diabetes were given berberine (480 mg) or metformin (1000 mg) daily for 3 months. Conclusion: Berberine was as effective as metformin in reducing blood glucose and controlling type 2 diabetes. Both groups lost weight.
Study 2
A systematic review and meta-analysis of 37 studies involving patients with Type 2 diabetes and berberine supplementation, which lasted 14 days to 6 months, concluded that berberine was statistically significant for reducing fasting glucose A1C levels.
Study 3
A systematic review and meta-analysis of 18 studies involving metabolic disorders and berberine supplementation concluded:
Fact: Many holistic approaches can be effective in reducing or alleviating muscle and joint pain. Changes in diet, stretching, physical therapy, chiropractic, cold laser therapy, acupuncture and others can be very helpful. In terms of supplementation, there is good research with palmitoylethanolamide (PEA). PEA is a naturally occurring fatty acid derivative made in the body and found in small amounts in foods such as soy lecithin, egg yolk, and peanut meal. This naturally occurring substance is a game changer for the treatment of pain and inflammation. As the journal Nutrients reports, PEA is:
*A broad-spectrum analgesic
*Anti-inflammatory
*Neuroprotective
In terms of the quality of pain relief, it has been shown to reduce acute pain, inflammatory pain, and nerve-related pain. A 2023 review of 11 studies in which patients had various types of pain (muscles, joints, neurological, gynecological, digestive) found that PEA provided significant pain-relieving effects.
A 2021 randomized, double-blind study compared 350 mg of Levagen™ to a placebo for two weeks to reduce adult joint pain. Pain scores were significantly reduced in the Levagen™ group compared to the placebo.
A 2019 randomized, double-blind placebo-controlled study was completed in adults with mild to moderate knee osteoarthritis. 111 participants received Levagen™ 300 mg, 600 mg, or placebo each day. There was significant pain and anxiety improvement in the Levagen ™ groups.
Eight clinical trials involving 1366 patients demonstrated that PEA is a safe and effective treatment for sciatic pain, low back pain, and carpal tunnel syndrome. Moreover, a study of 636 patients with sciatica found that supplementation of PEA for three weeks resulted in a 60% reduction in pain.
The International Journal of Nutrition and Food Sciences reports: “The safety profile of PEA has been well researched for over 50 years and evidence suggests that doses up to 1,200 mg/day have no harmful effects.”
I normally use the combination of PEA and high absorbable turmeric with my patients.
Asbaghi, O., Ghanbari, N., shekari, M., Reiner, Ž., Amirani, E., Hallajzadeh, J., Mirsafaei, L., & Asemi, Z. (2020). The effect of berberine supplementation on obesity parameters, inflammation and liver function enzymes: A systematic review and meta-analysis of randomized controlled trials. Clinical Nutrition ESPEN, 38, 43–49. https://doi.org/10.1016/j.clnesp.2020.04.010
Duggan, Michael P.; Kodali, Anahita T.; Panton, Zach A.; Smith, Shannon M.; Riew, Grant J.; Donaghue, Jack F.; Leya, Gregory A.; and Briggs, Logan G. (2023) "Survey of Nutrition Education Among Medical Students," Journal of Wellness: Vol. 4 : Iss. 2 , Article 11.
DOI: https://doi.org/10.55504/2578-9333.1167
Ferguson, L. R., De Caterina, R., Görman, U., Allayee, H., Kohlmeier, M., Prasad, C., Choi, M. S., Curi, R., de Luis, D. A., Gil, Á., Kang, J. X., Martin, R. L., Milagro, F. I., Nicoletti, C. F., Nonino, C. B., Ordovas, J. M., Parslow, V. R., Portillo, M. P., Santos, J. L., Martinez, J. A. (2016). Guide and position of the International Society of Nutrigenetics/Nutrigenomics on personalised nutrition: Part 1 - fields of precision nutrition. Lifestyle Genomics, 9(1), 12–27. https://doi.org/10.1159/000445350
Kip, K. E., Diamond, D., Mulukutla, S., & Marroquin, O. C. (2024). Is LDL cholesterol associated with long-term mortality among primary prevention adults? A retrospective cohort study from a large healthcare system. BMJ Open, 14(3). https://doi.org/10.1136/bmjopen-2023-077949
Ghosh, Siddhartha S, Jing Wang, Paul J Yannie, and Shobha Ghosh. “Intestinal Barrier Dysfunction, LPS Translocation, and Disease Development.” Journal of the Endocrine Society 4, no. 2 (February 1, 2020). https://doi.org/10.1210/jendso/bvz039.Kinashi, Yusuke, and Koji Hase. “Partners in Leaky Gut Syndrome: Intestinal Dysbiosis and Autoimmunity.” Frontiers in Immunology 12 (April 22, 2021). https://doi.org/10.3389/fimmu.2021.673708.
Marcelo Campos, MD. “Leaky Gut: What Is It, and What Does It Mean for You?” Harvard Health, November 16, 2021. https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451.
“Phytochemicals: The Cancer Fighters in Your Foods,” American Institute for Cancer Research, accessed September 2017, http://www.aicr.org/reduce-your-cancer-risk/diet/
elements_phytochemicals.html.
Sanjari, M., Shamsinejad, B., Khazaeli, P., Safi, Z., Mirrashidi, F., & Naghibzadeh-Tahami, A. (2020). Safety and efficacy of Berberis integerrima root extract in patients with type 2 diabetes. A parallel intervention based triple blind clinical trial. Journal of diabetes and metabolic disorders, 19(1), 71–80. https://doi.org/10.1007/s40200-019-00478-z
The genetics of cancer. NCI. (n.d.). https://www.cancer.gov/about-cancer/causes-prevention/genetics
UnitedHealth Group. (2023, December 5). America’s Health Rankings 2023 annual report: Chronic conditions on the rise. https://www.unitedhealthgroup.com/newsroom/posts/2023/2023-12-05-ahr-annual-report-2023.html
Xie, W., Su, F., Wang, G., Peng, Z., Xu, Y., Zhang, Y., Xu, N., Hou, K., Hu, Z., Chen, Y., & Chen, R. (2022). Glucose-lowering effect of berberine on type 2 diabetes: A systematic review and meta-analysis. Frontiers in pharmacology, 13, 1015045. https://doi.org/10.3389/fphar.2022.1015045
