THE PATH AHEAD
Hard to be Healthy in North America Joseph Pizzorno, ND, Editor in Chief
I
lecture a lot these days, literally all over the world (in 2015: Australia, Canada, Japan, New Zealand, Norway, the United Kingdom, and the United States). These days, the primary topic I am asked to present is toxicity/ detoxification, which I now believe is the primary driver of chronic disease in Western societies. No, I am not saying malnutrition is no longer important as a key driver of disease; we’ve unfortunately added another cause of disease that is even more of a problem. When lecturing in New Zealand a few years ago, my first meal was breakfast at an arbitrary hotel in Auckland. I was astounded by the bright, deep orange of the egg yolks and the remarkable depth and variety of flavor in the meal. This pattern repeated throughout our motorcycle tour of the 2 islands—wherever we went (with 1 notable exception), the food was colorful and flavorful. In April, I was lecturing and motorcycle touring in Australia and had the same experience of high-quality food everywhere (except in the big cities where the food was clearly of lower quality). The weekend I returned to the United States, I attended the wedding of a niece in Texas. The omelet at the advertised “healthy” restaurant was pale and tasteless. As I looked around and saw all the obese, apparently low vitality people, I had a visceral “aha” moment: Even those who try to eat healthfully are sabotaged by conventionally grown food. The foods are depleted of nutrients and are
high in toxins. With only 20% of disease due to genetics and the rest due to diet, environment, and lifestyle, no wonder ill health is so rampant and incidence of chronic disease is increasing. As readers of IMCJ well know, our bodies are basically enzyme machines. Enzymes are intricate proteins needing cofactors to work. As most cofactors are vitamins and minerals, the enzyme machine malfunctions if these are not present in the foods we eat or supplements we take. Worse, a key mechanism for how toxins cause disease is by displacing vitamin and mineral cofactors from enzymes, an action whose impact is even worse when nutrients are depleted. Conventionally grown foods typically account for around 75% of the environmental toxin load. The combination of nutrient depletion and high toxin contamination in the food supply is deadly. The Incidence of Chronic Disease Is Increasing The incidence of chronic disease is increasing. While medical apologists say this is because the population is aging, the harsh reality is that chronic disease is increasing in all age groups, even young people. Perhaps nowhere is this more evident than in type 2 diabetes mellitus. As can be seen in Figure 1, the incidence of type 2 diabetes (using the same diagnostic criteria) has increased dramatically in the past half century.
Figure 1. The rising incidence of diabetes.1
8
Integrative Medicine • Vol. 14, No. 3 • June 2015
Number With Diabetes (Millions)
Percentage With Diabetes
Number and Percentage of US Population with Diagnosed Diabetes, 1958-2013
Pizzorno—The Path Ahead
Figure 2. Sugar consumption in the United States (added sugars: glucose, sucrose, high-fructose corn syrup, and maple syrup).2
Figure 3. Incidence of 2 or more chronic diseases (of 9 selected).4 60
Percentage
50
49.0a
45.3a 39.2
37.2
40
42.5a 35.8
30 20
16.1
21.0a
20.6a 15.2
16.9
21.3a
10 0
Total
Men 45-64
Women
Age in Years
Significantly different from 1999–2000, P < .05.
a
Our genetics have not changed, so what happened? Are we eating more sugar? Yes, but as can be seen in Figure 2, the increase is not consistent with the diabetes epidemic. Something fundamentally important happened in the 1960s that dramatically accelerated the diabetes epidemic. Eating sugar, lack of exercise, and obesity are certainly important contributing factors. However, the total load of toxins such as arsenic and persistent organic pollutants (POPs) is now by far the strongest cause of diabetes. Those Pizzorno—The Path Ahead
Total
Men 65 and over
Women
1999-2000 2009-2010 in the top quintile of exposure to 6 common POPs have a 37.7-fold increased risk of diabetes—much stronger than any other known risk factor. Interestingly, if an obese person is low in toxins, the normally robust association between diabetes and obesity disappears.3 The disconcerting data shows that chronic disease is increasing in all age groups as shown in Figure 3. While the diabetes data is most dramatic, the incidence of virtually all chronic diseases is increasing rapidly. “Houston, we have a problem.” Integrative Medicine • Vol. 14, No. 3 • June 2015
9
The Nutrient Content of Conventionally Grown Foods Has Decreased Precipitously Modern agricultural methods produce food that is bigger and grows faster, but it is lower in nutrients, especially the trace minerals. As can be seen in Figure 4, the mineral content of foods has dropped dramatically. Without these critical cofactors for the enzymes, how can we expect our bodies to work? Figure 4. Mineral content of vegetables, fruit, meat, and dairy over 50 years.5 10% 0%
Na
-10%
K
-20% -30%
Mg
-40%
Ca
-50%
Fe
-60%
Cu
-70%
Zn bles geta
Ve
it Fru
t Mea
0.30 0.25
0.15
Figure 5. Increasing use of high phosphate fertilizers decreases nutrient content of foods (PPM phosphorous).6 1.4
0.10 0.05 0.00
Conventional
Organic
Organophosphate in Urine (Um/L)
Relative Concentration
1.2 1.0
0 22 44
0.8 0.6 0.4 0.2
10
0.35
0.20
ry Dai
The cause of this serious loss of minerals appears due to 3 factors: change in cultivars; depletion of mineral content of soil after decades of synthetic fertilizers; and high phosphate fertilizers that cause foods to grow bigger, which dilutes their nutrient content. Figure 5 clearly shows how increasing concentration of synthetic fertilizers dilutes mineral content.
0.0
Environmental Toxin Load Continues to Increase After looking at a lot of research, I am now convinced that toxin load has become the primary cause of chronic disease in the Western world. The primary, but certainly not only, source of toxins is from the foods we eat. This is dramatically shown in Figure 6, which measures organophosphate pesticides in children. Those eating conventionally grown foods have a disconcerting 9-fold increase—to levels known to cause psychoneurological dysfunction. Figure 6. Organophosphate pesticides in children eating conventionally versus organically grown foods.8
P
-80%
One disconcerting study shows that the trace mineral content of US wheat in the past 122 years has decreased by 20% to 33%. Bottom line, the foods the average person eats are truly depleted of nutrients.7
P
N
K Ca Mg Mn Cu
Integrative Medicine • Vol. 14, No. 3 • June 2015
B
Zn
Toxic load has consequences. Table 1 shows just a few of the many strong correlations between toxic load and disease burden. Going back to the diabetes epidemic, Figure 7 shows a very compelling association (which, of course, is not proof of cause) with the production of POPs. Note that the production numbers are in billions of kilograms per year. As POPs block insulin receptor sites, decrease GLUT-4 activity in muscles, and decrease insulin production, a causal relationship appears highly probable.20,21 Pizzorno—The Path Ahead
Table 1. Toxic Load and Disease Risk (Highest Quintile or Quartile Compared With Lowest) Toxin
Disease
Risk
Reference
Arsenic
Diabetes
3.6
Navas-Acien A et al9
Lung cancer
3.0-5.0
Heck JE et al10
Myocardial infarction
1.8
Everett CJ et al11
Osteoporosis
1.4
Gallagher CM et al12
Diabetes
9.1
Jacobs et al13
Rheumatoid arthritis
3.5
Lee DH et al14
Cadmium Organochlorine pesticides
Organophosphate pesticides IQ in children according to OPs in mother
7.1-point Bouchard MF et al15 decrease in IQ
ADHD
2.0
Bouchard MF et al16
PCBs
ADHD
>3.0
Boersma ER et al17
Polybrominated diphenyl ethers
Diabetes
2.0-3.0
Lim JS et al16
Polychlorinated biphenyls
Rheumatoid arthritis
8.5
Lee DH et al14
Abbreviations: IQ, intelligence quotient; PCBs, polychlorinated biphenyls; ADHD, attention-deficit/hyperactivity disorder. Figure 7. Incidence of diabetes correlates with the production of POPs.19
Conclusion The longer I study the research and care for patients, the more compelling I find the old time concept, “Foundations of Health.” While our growing sophistication with nutritional biochemistry is very important and of Pizzorno—The Path Ahead
great benefit for our patients, therapeutic nutrition has limited benefit if we don’t first ensure the basics of health: eating real food rich in nutrients and avoiding toxins as much as possible.
Integrative Medicine • Vol. 14, No. 3 • June 2015
11
In This Issue Original research this issue is by Hector L. Lopez, MD; Tim N. Ziegenfuss, PhD; and Joosang Park, PhD. Their pilot study showing that a cartilage extract helps decrease tissue damage and increase recovery from exercise is very encouraging. I hope they move quickly to a larger, controlled study. Those of us with silver hair who continue to exercise diligently need all the help we can get! As a teacher, I must admit to great satisfaction when those who were once my students become expert clinicians and help advance our therapeutic understanding. Douglas Lobay, BSc, ND, through clinical study and careful review of the research literature, is helping bring back the traditional use of Rauwolfia in the treatment of hypertension. He makes a compelling case that, with proper indications and dosing, this botanical medicine is a great resource for integrative medicine. Another important outcome from his article is showing how inappropriate inclusion/ exclusion criteria in research designs can give seriously erroneous results. Nonetheless, we are not recommending here use of Rauwolfia in place of appropriate diet, nutritional, and lifestyle intervention. Rather, this plant medicine can be an important addition in comprehensive care of patients with cardiovascular disease. Brian Anderson, DC, CCN, MPH, MS, provides us a case report on how smart dietary guidance helped a patient with ichthyosis vulgaris. I found especially encouraging that diet and supplements worked better than symptomtreating drugs. More case histories please! Clyde B. Jensen, PhD, is, as far as I know, unique in medical education: He is the only person who has been the president of a conventional, naturopathic, and osteopathic medical school and vice president of chiropractic and Chinese medicine institutions! This gives him a remarkable breadth and depth of understanding of the professions. His work helps us develop a better understanding of the continuum of health care professions. John Weeks has raised a big warning flag that the National Center for Complementary and Integrative Health (NCCIH) Advisory Council has now lost almost all of its licensed complementary and alternative medicine (CAM) professionals. This is in direct violation of the congressional mandate that this group make up at least one-half of the membership. While creation of the now renamed National Center for Complementary and Alternative Medicine (NCCAM) was being considered in Congress, many of us worked diligently with Senator Tom Harkin (D-Iowa) and others to get this language into the legislation. We wanted to ensure that the experts in the field of natural medicine—by whatever name—would be fully included in the development of important federal policy. I would like to remind the “powers that be” that these “new” concepts of healthy living, nutritional optimization, toxin avoidance, etc were kept alive in the culture by the natural medicine professionals despite onerous suppression by the conventional medicine trade 12
Integrative Medicine • Vol. 14, No. 3 • June 2015
unions. The body of knowledge—and even more important, understanding of health and disease found in natural medicine—is critical to solving the health care crisis. In fact, I would assert this understanding is ultimately the ONLY solution to the health care crisis. I hope you dear readers are enjoying our interviews as much as I am. At IMCJ, we have been working to provide an opportunity to hear from innovators in integrative medicine who may not be well known but have developed clinically important insights. Our first this issue is with Kevin Spelman, PhD, MCPP. His research helping move Cannabis from being considered only recreational to becoming recognized as a very important medicinal plant. I will also be speaking at the NorthWest Herb Symposium, on Whidbey Island, Washington, August 27 through 30, 2015, and I am very much looking forward to attending his lecture. Our second interview is with Denis Wilson, MD, on his important clinical work with hypothyroidism. I fully concur that this is a much more prevalent problem than generally recognized. I think few are aware that iodine consumption in North America has decreased by more than 50%. To make matters worse, bromine—which blocks iodine receptor sites—consumption has increased as has exposure to chemical toxins which disrupt thyroid T4 production and its conversion to the more active T3. Good luck Bill Benda, MD, associate editor, with your move to sunnier clime and warmer ocean water. I fully concur—live life fully.
Joseph Pizzorno, ND, Editor in Chief [email protected] http://twitter.com/drpizzorno References
1. Centers for Disease Control and Prevention. Number and percentage of US population with diagnosed diabetes, 1958-2009. http://www.cdc.gov/ diabetes/statistics/prevalence_national.htm. Accessed May 10, 2015. 2. Guyenet S. By 2606, the US diet will be 100 percent sugar. Whole Health Source Web site. http://wholehealthsource.blogspot.com/2012/02/by-2606us-diet-will-be-100-percent.html. Published February 18, 2012. Accessed May 10, 2015. 3. Lee DH, Lee IK, Song K, et al. A strong dose-response relation between serum concentrations of persistent organic pollutants and diabetes: results from the National Health and Examination Survey 1999-2002. Diabetes Care. 2006;29(7):1638-1644. 4. Freid VM, Bernstein AB, Bush MA. Multiple chronic conditions among adults aged 45 and over: trends over the past 10 years. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/nchs/data/databriefs/ db100.htm. Updated July 31, 2012. Accessed May 5, 2012. 5. Thomas D. A study on the mineral depletion of the foods available to US as a nation over the period 1940 to 1991. Nutr Health. 2003;17(2):85-115 6. Hughes M, Chaplin MH, Martin LW. Influence of mycorrhiza on the nutrition of red raspberries. HortScience. 1979;14:521-523. 7. Garvin DF, Welch RM, Finley JW. Historical shifts in the seed mineral micronutrient concentration of US hard red winter wheat germplasm. J Sci Food Agr. 2006;86:2213-2220. 8. Curl CL, Fenske RA, Elgethun K. Organophosphorus pesticide exposure of urban and suburban preschool children with organic and conventional diets. Environ Health Perspect. 2003;111(3):377-382.
Pizzorno—The Path Ahead
9. Navas-Acien A, Silbergeld EK, Pastor-Barriuso R, Guallar E. Arsenic exposure and prevalence of type 2 diabetes in US adults. JAMA. 2008;300(7):814-822. 10. Heck JE, Andrew AS, Onega T, et al. Lung cancer in a US population with low to moderate arsenic exposure. Environ Health Perspect. 2009;117(11):1718-1723. 11. Everett CJ, Frithsen IL. Association of urinary cadmium and myocardial infarction. Environ Res. 2008;106(2):284-286. 12. Gallagher CM, Kovach JS, Meliker JR. Urinary cadmium and osteoporosis in US Women > or = 50 years of age: NHANES 1988-1994 and 1999-2004. Environ Health Perspect. 2008;116(10):1338-1343. 13. Jacobs MN, Nolan GT, Hood SR. Lignans, bacteriocides and organochlorine compounds activate the human pregnane X receptor (PXR). Toxicol Appl Pharmacol. 2005;209(2):123-133. 14. Lee DH, Steffes M, Jacobs DR. Positive associations of serum concentration of polychlorinated biphenyls or organochlorine pesticides with self-reported arthritis, especially rheumatoid type, in women. Environ Health Perspect. 2007;115(6):883-888. 15. Bouchard MF, Chevrier J, Harley KG, et al. prenatal exposure to organophosphate pesticides and IQ in 7-year-old children. Environ Health Perspect. 2011;119(8):1189-1195. 16. Bouchard MF, Bellinger DC, Wright RO, Weisskopf MG. Attention-deficit/ hyperactivity disorder and urinary metabolites of organophosphate pesticides. Pediatrics. 2010;125(6):e1270-e1277. 17. Boersma ER, Lanting CI. Environmental exposure to polychlorinated biphenyls (PCBs) and dioxins. Consequences for long term neurological and cognitive development of the child lactation. Adv Exp Med Biol. 2000;478:271-287. 18. Lim JS, Lee DH, Jacobs DR Jr. Association of brominated flame retardants with diabetes and metabolic syndrome in the US population, 2003-2004. Diabetes Care. 2008;31(9):1802-1807. 19. Neel BA, Robert M. Sargis RM. The paradox of progress: Environmental disruption of metabolism and the diabetes epidemic. Diabetes. 2011;60(7):1838-1848. 20. Lee DH, Lee IK, Jin SH, Steffes M, Jacobs DR Jr. Association between serum concentrations of persistent organic pollutants and insulin resistance among nondiabetic adults: results from the National Health and Nutrition Examination Survey 1999-2002. Diabetes Care. 2007;30(3):622-628. 21. Ukropec J, Radikova Z, Huckova M, et al. High prevalence of prediabetes and diabetes in a population exposed to high levels of an organochlorine cocktail. Diabetologia. 2010;53(5):899-906.
Hard to be Healthy in North America Joseph Pizzorno, ND, Editor in Chief
I
lecture a lot these days, literally all over the world (in 2015: Australia, Canada, Japan, New Zealand, Norway, the United Kingdom, and the United States). These days, the primary topic I am asked to present is toxicity/ detoxification, which I now believe is the primary driver of chronic disease in Western societies. No, I am not saying malnutrition is no longer important as a key driver of disease; we’ve unfortunately added another cause of disease that is even more of a problem. When lecturing in New Zealand a few years ago, my first meal was breakfast at an arbitrary hotel in Auckland. I was astounded by the bright, deep orange of the egg yolks and the remarkable depth and variety of flavor in the meal. This pattern repeated throughout our motorcycle tour of the 2 islands—wherever we went (with 1 notable exception), the food was colorful and flavorful. In April, I was lecturing and motorcycle touring in Australia and had the same experience of high-quality food everywhere (except in the big cities where the food was clearly of lower quality). The weekend I returned to the United States, I attended the wedding of a niece in Texas. The omelet at the advertised “healthy” restaurant was pale and tasteless. As I looked around and saw all the obese, apparently low vitality people, I had a visceral “aha” moment: Even those who try to eat healthfully are sabotaged by conventionally grown food. The foods are depleted of nutrients and are
high in toxins. With only 20% of disease due to genetics and the rest due to diet, environment, and lifestyle, no wonder ill health is so rampant and incidence of chronic disease is increasing. As readers of IMCJ well know, our bodies are basically enzyme machines. Enzymes are intricate proteins needing cofactors to work. As most cofactors are vitamins and minerals, the enzyme machine malfunctions if these are not present in the foods we eat or supplements we take. Worse, a key mechanism for how toxins cause disease is by displacing vitamin and mineral cofactors from enzymes, an action whose impact is even worse when nutrients are depleted. Conventionally grown foods typically account for around 75% of the environmental toxin load. The combination of nutrient depletion and high toxin contamination in the food supply is deadly. The Incidence of Chronic Disease Is Increasing The incidence of chronic disease is increasing. While medical apologists say this is because the population is aging, the harsh reality is that chronic disease is increasing in all age groups, even young people. Perhaps nowhere is this more evident than in type 2 diabetes mellitus. As can be seen in Figure 1, the incidence of type 2 diabetes (using the same diagnostic criteria) has increased dramatically in the past half century.
Figure 1. The rising incidence of diabetes.1
8
Integrative Medicine • Vol. 14, No. 3 • June 2015
Number With Diabetes (Millions)
Percentage With Diabetes
Number and Percentage of US Population with Diagnosed Diabetes, 1958-2013
Pizzorno—The Path Ahead
Figure 2. Sugar consumption in the United States (added sugars: glucose, sucrose, high-fructose corn syrup, and maple syrup).2
Figure 3. Incidence of 2 or more chronic diseases (of 9 selected).4 60
Percentage
50
49.0a
45.3a 39.2
37.2
40
42.5a 35.8
30 20
16.1
21.0a
20.6a 15.2
16.9
21.3a
10 0
Total
Men 45-64
Women
Age in Years
Significantly different from 1999–2000, P < .05.
a
Our genetics have not changed, so what happened? Are we eating more sugar? Yes, but as can be seen in Figure 2, the increase is not consistent with the diabetes epidemic. Something fundamentally important happened in the 1960s that dramatically accelerated the diabetes epidemic. Eating sugar, lack of exercise, and obesity are certainly important contributing factors. However, the total load of toxins such as arsenic and persistent organic pollutants (POPs) is now by far the strongest cause of diabetes. Those Pizzorno—The Path Ahead
Total
Men 65 and over
Women
1999-2000 2009-2010 in the top quintile of exposure to 6 common POPs have a 37.7-fold increased risk of diabetes—much stronger than any other known risk factor. Interestingly, if an obese person is low in toxins, the normally robust association between diabetes and obesity disappears.3 The disconcerting data shows that chronic disease is increasing in all age groups as shown in Figure 3. While the diabetes data is most dramatic, the incidence of virtually all chronic diseases is increasing rapidly. “Houston, we have a problem.” Integrative Medicine • Vol. 14, No. 3 • June 2015
9
The Nutrient Content of Conventionally Grown Foods Has Decreased Precipitously Modern agricultural methods produce food that is bigger and grows faster, but it is lower in nutrients, especially the trace minerals. As can be seen in Figure 4, the mineral content of foods has dropped dramatically. Without these critical cofactors for the enzymes, how can we expect our bodies to work? Figure 4. Mineral content of vegetables, fruit, meat, and dairy over 50 years.5 10% 0%
Na
-10%
K
-20% -30%
Mg
-40%
Ca
-50%
Fe
-60%
Cu
-70%
Zn bles geta
Ve
it Fru
t Mea
0.30 0.25
0.15
Figure 5. Increasing use of high phosphate fertilizers decreases nutrient content of foods (PPM phosphorous).6 1.4
0.10 0.05 0.00
Conventional
Organic
Organophosphate in Urine (Um/L)
Relative Concentration
1.2 1.0
0 22 44
0.8 0.6 0.4 0.2
10
0.35
0.20
ry Dai
The cause of this serious loss of minerals appears due to 3 factors: change in cultivars; depletion of mineral content of soil after decades of synthetic fertilizers; and high phosphate fertilizers that cause foods to grow bigger, which dilutes their nutrient content. Figure 5 clearly shows how increasing concentration of synthetic fertilizers dilutes mineral content.
0.0
Environmental Toxin Load Continues to Increase After looking at a lot of research, I am now convinced that toxin load has become the primary cause of chronic disease in the Western world. The primary, but certainly not only, source of toxins is from the foods we eat. This is dramatically shown in Figure 6, which measures organophosphate pesticides in children. Those eating conventionally grown foods have a disconcerting 9-fold increase—to levels known to cause psychoneurological dysfunction. Figure 6. Organophosphate pesticides in children eating conventionally versus organically grown foods.8
P
-80%
One disconcerting study shows that the trace mineral content of US wheat in the past 122 years has decreased by 20% to 33%. Bottom line, the foods the average person eats are truly depleted of nutrients.7
P
N
K Ca Mg Mn Cu
Integrative Medicine • Vol. 14, No. 3 • June 2015
B
Zn
Toxic load has consequences. Table 1 shows just a few of the many strong correlations between toxic load and disease burden. Going back to the diabetes epidemic, Figure 7 shows a very compelling association (which, of course, is not proof of cause) with the production of POPs. Note that the production numbers are in billions of kilograms per year. As POPs block insulin receptor sites, decrease GLUT-4 activity in muscles, and decrease insulin production, a causal relationship appears highly probable.20,21 Pizzorno—The Path Ahead
Table 1. Toxic Load and Disease Risk (Highest Quintile or Quartile Compared With Lowest) Toxin
Disease
Risk
Reference
Arsenic
Diabetes
3.6
Navas-Acien A et al9
Lung cancer
3.0-5.0
Heck JE et al10
Myocardial infarction
1.8
Everett CJ et al11
Osteoporosis
1.4
Gallagher CM et al12
Diabetes
9.1
Jacobs et al13
Rheumatoid arthritis
3.5
Lee DH et al14
Cadmium Organochlorine pesticides
Organophosphate pesticides IQ in children according to OPs in mother
7.1-point Bouchard MF et al15 decrease in IQ
ADHD
2.0
Bouchard MF et al16
PCBs
ADHD
>3.0
Boersma ER et al17
Polybrominated diphenyl ethers
Diabetes
2.0-3.0
Lim JS et al16
Polychlorinated biphenyls
Rheumatoid arthritis
8.5
Lee DH et al14
Abbreviations: IQ, intelligence quotient; PCBs, polychlorinated biphenyls; ADHD, attention-deficit/hyperactivity disorder. Figure 7. Incidence of diabetes correlates with the production of POPs.19
Conclusion The longer I study the research and care for patients, the more compelling I find the old time concept, “Foundations of Health.” While our growing sophistication with nutritional biochemistry is very important and of Pizzorno—The Path Ahead
great benefit for our patients, therapeutic nutrition has limited benefit if we don’t first ensure the basics of health: eating real food rich in nutrients and avoiding toxins as much as possible.
Integrative Medicine • Vol. 14, No. 3 • June 2015
11
In This Issue Original research this issue is by Hector L. Lopez, MD; Tim N. Ziegenfuss, PhD; and Joosang Park, PhD. Their pilot study showing that a cartilage extract helps decrease tissue damage and increase recovery from exercise is very encouraging. I hope they move quickly to a larger, controlled study. Those of us with silver hair who continue to exercise diligently need all the help we can get! As a teacher, I must admit to great satisfaction when those who were once my students become expert clinicians and help advance our therapeutic understanding. Douglas Lobay, BSc, ND, through clinical study and careful review of the research literature, is helping bring back the traditional use of Rauwolfia in the treatment of hypertension. He makes a compelling case that, with proper indications and dosing, this botanical medicine is a great resource for integrative medicine. Another important outcome from his article is showing how inappropriate inclusion/ exclusion criteria in research designs can give seriously erroneous results. Nonetheless, we are not recommending here use of Rauwolfia in place of appropriate diet, nutritional, and lifestyle intervention. Rather, this plant medicine can be an important addition in comprehensive care of patients with cardiovascular disease. Brian Anderson, DC, CCN, MPH, MS, provides us a case report on how smart dietary guidance helped a patient with ichthyosis vulgaris. I found especially encouraging that diet and supplements worked better than symptomtreating drugs. More case histories please! Clyde B. Jensen, PhD, is, as far as I know, unique in medical education: He is the only person who has been the president of a conventional, naturopathic, and osteopathic medical school and vice president of chiropractic and Chinese medicine institutions! This gives him a remarkable breadth and depth of understanding of the professions. His work helps us develop a better understanding of the continuum of health care professions. John Weeks has raised a big warning flag that the National Center for Complementary and Integrative Health (NCCIH) Advisory Council has now lost almost all of its licensed complementary and alternative medicine (CAM) professionals. This is in direct violation of the congressional mandate that this group make up at least one-half of the membership. While creation of the now renamed National Center for Complementary and Alternative Medicine (NCCAM) was being considered in Congress, many of us worked diligently with Senator Tom Harkin (D-Iowa) and others to get this language into the legislation. We wanted to ensure that the experts in the field of natural medicine—by whatever name—would be fully included in the development of important federal policy. I would like to remind the “powers that be” that these “new” concepts of healthy living, nutritional optimization, toxin avoidance, etc were kept alive in the culture by the natural medicine professionals despite onerous suppression by the conventional medicine trade 12
Integrative Medicine • Vol. 14, No. 3 • June 2015
unions. The body of knowledge—and even more important, understanding of health and disease found in natural medicine—is critical to solving the health care crisis. In fact, I would assert this understanding is ultimately the ONLY solution to the health care crisis. I hope you dear readers are enjoying our interviews as much as I am. At IMCJ, we have been working to provide an opportunity to hear from innovators in integrative medicine who may not be well known but have developed clinically important insights. Our first this issue is with Kevin Spelman, PhD, MCPP. His research helping move Cannabis from being considered only recreational to becoming recognized as a very important medicinal plant. I will also be speaking at the NorthWest Herb Symposium, on Whidbey Island, Washington, August 27 through 30, 2015, and I am very much looking forward to attending his lecture. Our second interview is with Denis Wilson, MD, on his important clinical work with hypothyroidism. I fully concur that this is a much more prevalent problem than generally recognized. I think few are aware that iodine consumption in North America has decreased by more than 50%. To make matters worse, bromine—which blocks iodine receptor sites—consumption has increased as has exposure to chemical toxins which disrupt thyroid T4 production and its conversion to the more active T3. Good luck Bill Benda, MD, associate editor, with your move to sunnier clime and warmer ocean water. I fully concur—live life fully.
Joseph Pizzorno, ND, Editor in Chief [email protected] http://twitter.com/drpizzorno References
1. Centers for Disease Control and Prevention. Number and percentage of US population with diagnosed diabetes, 1958-2009. http://www.cdc.gov/ diabetes/statistics/prevalence_national.htm. Accessed May 10, 2015. 2. Guyenet S. By 2606, the US diet will be 100 percent sugar. Whole Health Source Web site. http://wholehealthsource.blogspot.com/2012/02/by-2606us-diet-will-be-100-percent.html. Published February 18, 2012. Accessed May 10, 2015. 3. Lee DH, Lee IK, Song K, et al. A strong dose-response relation between serum concentrations of persistent organic pollutants and diabetes: results from the National Health and Examination Survey 1999-2002. Diabetes Care. 2006;29(7):1638-1644. 4. Freid VM, Bernstein AB, Bush MA. Multiple chronic conditions among adults aged 45 and over: trends over the past 10 years. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/nchs/data/databriefs/ db100.htm. Updated July 31, 2012. Accessed May 5, 2012. 5. Thomas D. A study on the mineral depletion of the foods available to US as a nation over the period 1940 to 1991. Nutr Health. 2003;17(2):85-115 6. Hughes M, Chaplin MH, Martin LW. Influence of mycorrhiza on the nutrition of red raspberries. HortScience. 1979;14:521-523. 7. Garvin DF, Welch RM, Finley JW. Historical shifts in the seed mineral micronutrient concentration of US hard red winter wheat germplasm. J Sci Food Agr. 2006;86:2213-2220. 8. Curl CL, Fenske RA, Elgethun K. Organophosphorus pesticide exposure of urban and suburban preschool children with organic and conventional diets. Environ Health Perspect. 2003;111(3):377-382.
Pizzorno—The Path Ahead
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