Health and Wellness Catalyst Newsletter Archive: Fall, 2014

Health and Wellness Catalyst Newsletter Archive:  Fall, 2014

Welcome to the Fall edition of the Health and Wellness Catalyst.  I hope everyone is doing well.  This newsletter will primarily be from the International Research Congress in Integrative Medicine and Health held in Miami, May 13^th - 16th.  It was a great conference to reconnect with colleagues, meet new people and hear inspiring talks on a range of topics.  All of the articles come from the conference and they are: (1) Nutrition – New information about probiotics, the gut microbiome and the nervous system; (2) Health coaching – An update and description of the field of health coaching – a vital part of behavioral change in the emerging healthcare system; and (3) Integrative medicine – New research describing the incredible and measurable biological effects of relaxation techniques such as mindfulness, yoga and tai chi.

Nutrition:  New information about probiotics, the gut microbiome and influences on the nervous system

This session was led my John Bienenstock, PhD, of McMaster University and Kristen Tillisch, MD of UCLA.  John described his work with colleagues and a series of studies that showed that the specific mechanisms of feedback from the ‘gut brain’ to the central nervous system were via the vagus nerve and biomolecules produced from the bowel flora that interact with sensory neurons.  One study that he described was in mice who were supplemented with Lactobacillus rhamnosus which produced the following effects: (1) region specific effects on GABA receptors (increased in some regions and decreased in others); and (2) reduced stress-induced corticosterone, and anxiety and depressive behavior.  An associated study showed that these effects were not seen in vagotomized mice, suggesting that the major communication pathway was via the vagus nerve.

Kristen described some of her research that has looked at predominantly plant-based or carbohydrate eaters, who had a significant presence of Prevotella species in their guts, in comparison to carnivores who have a significant presence of Bacteroides species in their GI tract.  It was the next study that was most interesting, in which she looked at women with different microbiota predominant organisms and found that they had different nervous system activity patterns.  She went on to say that there is still a tremendous amount of work to do because we still don’t have good information on 70-80 % of the gut microorganisms.  The focus of ongoing research is what is normal flora, how does it interact with the nervous system and what probiotics can be most helpful for the range of GI problems, nervous system or emotional symptoms/disorders and a range of other potentially related diseases.

Comment:  This is exciting and emerging research in animals and humans describing the interrelationships between the gut, and the nervous system/emotional well-being.  As we understand more about normal gut flora and its influences, we will be able to target probiotics that improve emotional and nervous system function in addition to stomach and intestinal function.

Health Coaching:  An update and description of the field of health coaching – a vital part of behavioral change in the emerging healthcare system

This was a concurrent session focusing on health coaching led by Karen Lawson, MD, Director of Integrative Health Coaching, University of Minnesota, and Ruth

Wolever, PhD, Director of Research, Duke Integrative Medicine (she also helped establish Duke’s integrative health coaching training program).   Ruth started out by talking about her research on the definition of health coaching – this shows you how health coaching research is truly in its infancy.  She also encouraged support of the non-profit organization which is working on certification criteria for health coaching, a must for the field to move forward – www.ncchwc.org  (National Consortium for Credentialing Health and Wellness Coaches) – with input and/or financing.  Ruth defined coaching as a process that brings together about 80 years of psychology research that combines the best approaches to how adults learn, motivational tools for creating lifestyle changes and sustaining change - this is all also put into the context of a client-centered approach, client determined agenda, self-discovery, accountability and a strong relationship.  Finally, Ruth described the best study to date showing a significant return on investment of 4:1 from a large study of over 174,000 people (stratified, randomized study to usual care or enhanced support), who were working with an insurance carrier from Portland, ME – subjects had chronic diseases and high healthcare costs (Wennberg DE, et al, NEJM, 2010 see ref below).

Karen described their program’s 4 pillars of health coaching practice as mindful presence, self-awareness, safe/sacred place and authentic communication.  She also described a study that she conducted with an insurance company in high-risk clients that showed significant changes in behavior and return on investment.

I also want to mention a presentation by Meg Jordan, PhD, RN of California Institute of Integral Studies – she presented some very interesting and inspiring work done with a homeless population in San Francisco.  While they found that these folks needed to have lodging security before they could effectively engage in a coaching process, it was inspiring to see how the work of coaching and empowerment can be used in a broad range of endeavors.

Comment:  Health coaching is poised to be the major vehicle for behavioral change in the healthcare system in the next 5-10 years, filling a vital and gaping hole in healthcare that will promote effective health outcomes.  On a personal note, I have found health coaching to be very helpful both personally and professionally, and I am excited about building up my health coaching practice with its whole-hearted and respectful approach to interpersonal relationships and personal transformation.

Integrative Medicine:  New research describing incredible and measurable biological effects of the relaxation techniques, mindfulness, yoga and tai chi.

This information came from plenary sessions presented by Steven Cole, PhD, from UCLA, “Social and Psychological Influences on Gene Expression;” Elissa Epel, PhD, from UCSF, “Mind, Body and Cellular Aging;” and a concurrent session, “Transforming the Understanding of Mind-Body Interventions: The Genomics of Stress and Resiliency,” in which the primary presenters, leaders in the field, were Michael Irwin, PhD, of UCLA, and Michael Antoni, PhD, of the University of Miami.

Steven spoke about a range of studies that have shown that psychological symptoms such as anxiety, loneliness and depression cause specific genetic activity that

increases inflammation and decreases immune resistance to viruses.  This has also been correlated with social loss, cancer diagnosis and lower SES.  From a mechanistic standpoint, mediating factors include stimulation of the HPA axis and the sympathetic nervous system, decreases in the number and activity of monocytes and dendritic cells.  He also described a range of other related research, too much to mention here.

Elissa spoke mostly about telemeres and telomerase activity which has been shown to correlate with longevity in that stresses have been shown to decrease telomere length (and decrease telemorase activity), where as stress reduction approaches such as membership in support groups (close and supportive relationships) have been shown to increase telomere length (and telemorase activity).  She has also looked at meditation effects, which are beneficial,  and in specific circumstances such as daily stress experience, autistic kids, anger and cancer survivorship.

Michael Irwin and Michael Antoni also added to the presented information by describing tai chi effects on viral immune responses, sleep quality, inflammation (and decreasing the cytokine NFKB) – the same effects were seen with yoga although not as much research was presented on yoga.  Michael Antoni focused on a cognitive behavioral stress management technique that improves coping and resiliency, particularly in cancer survivorship, and decreases pro-metastatic mechanisms.

Comment:  It was just incredible to see the degree to which we now have research that describes changes in genetic activity, brain activity, immune response, cytokine production, telomere length/telomerase activity and others that can have significant benefits in individuals with cancer and a range of there complex or chronic diseases, or more ‘simple’ stress related symptoms.

Cookbook Recommendation:  The Omni Diet, by Tana Amen, BSN, RN.  St. Martin’s Griffin, NY, 2013.  There are tasty recipes here for people who include

healthy proteins (vegetarian and animal products) and healthy plant-based foods.  Like many books on nutrition, some controversies discussed but overall very good.

References

Bravo JA, Forsythe P, Chew MV, et al.  Ingestion of Lactobacillus strain regulated emotional behavior and central GABA receptor expression in a mouse via the vagus nerve.  Proc Nat Acad Sci 2011;108:16050-5.

Bienenstock J, Gibson G, Klaenhammer TR, et al. New insights into probiotic mehanisms: a harvest from functional and metagenomic studies.  Gut Microbes 2013:4:94-100.

Tillisch K. The effects of gut microbiota on CNS function in humans.  Gut Microbes 2014;5:3 epub.

Wennberg DE, Marr A, Lang L, et al. A randomized trial of a telephone care-management strategy.  N Engl J Med  2010;363:1245-55.

Epel E, Lithgow GJ.  Stress biology and aging mechanisms: toward understanding the deep connection between adaptation to stress and longevity.  J Geronotol A Biol Sci Med Sci  2014;69S1:S10-16.   She also has multiple papers on a range of effects!

Vargas S, Antoni M, Carver CS, et al.  Sleep quality and fatigue after a stress management intervention for women with early-stage breast cancer in southern florida.  Int J Behav Med  2013;epub.

Hoyt MA, Stanton AL, … Irwin MR.  Inflammatory biomarkers and emotional approach coping in men with prostate cancer.  Brain Behav Immun  2013;32:173-9.