Greetings and welcome to my new blog – which is actually a
transition from a quarterly newsletter that I began in the Fall of 2014 and
continued into the Winter of 2015.
I am Dr. Joel and I help people transform their health through health coaching, nutrition and integrative medicine. You can get more information about my
expertise in health coaching, nutrition and integrative medicine from my linked
in profile, my google plus profile, and my website.
In this first post I wanted to provide a little background
and then refer to my three newsletters which are available here (Winter, 2015 is below, and Fall 2014 is in a separate post that follows). There are some interesting articles and
comments on health coaching, nutritional issues such as probiotics, vitamin D
(in relation to memory) and Coenzyme Q10 (and heart failure), and integrative
medicine (relaxation technique influences on aging, multiple sclerosis
treatment and hospital readmissions).
So again welcome and I look forward to providing
interesting, insightful and practical posts in the coming months and years.
To your health,
Dr. Joel
Welcome to the Winter edition of the Health and Wellness
Catalyst. I hope everyone is doing
well, having had a great Holiday and New Year. I have been busy with several new projects and changes that
I am excited about and will describe further in my newsletter section Edman
Wellness Services Update. The
articles that I have included in this issue are: (1) Nutrition – The
Effect of Coenzyme Q10 on Morbidity and Mortality in Chronic Heart Failure:
Results from Q-Symbio – a Randomized Double-Blind Trial. Mortensen SA, et
al. J Am College Cardiology HF
2014 epub ahead of print ; (2) Health coaching – The Effectiveness of Wellness
Coaching for Improving Quality of Life, Mayo Clinic Proc, Clark MM, et al.
2014 July 31 (Epub ahead of print); and (3) Integrative medicine – The
topic is Hospital Readmissions and there are two articles, Strategies to Help
Reduce Hospital Readmissions, J Family Practice, Snyderman D, et al.
2014;63:430-8; and Micronutrient Deficiencies:
an Unmet Need in Heart Failure, J Am Coll Cardiol, Soukoulis V, et al. 2009;54:1660-73.
Nutrition: Relationship between 25-hydroxyvitamin D and
cognitive function in older adults: the Health, Aging and Body Composition
Study.
This study adds cognition and mental functioning to the long
and growing list of disorders that deficient and/or insufficient vitamin D is
known to be associated with, including cardiovascular disease, cancer,
autoimmune disorders, diabetes, osteoporosis, depression, pain and possibly others. What is most interesting to me is that
the level of vitamin D at the beginning of the study was correlated with both
the cognition level (higher vitamin D level was associated with better
cognitive function) and the amount of cognitive decline (lower vitamin D level
was associated with greater change or worsening of cognitive measures) over the
four year period in which the participants were followed.
Research has tied vitamin D to variety of functions and
issues within the brain that may be important for maintaining healthy
functioning. These include the
vitamin D receptors found in many parts of the brain, vitamin D’s potential
mediating effect on anti-oxidant pathways (very important for maintaining nerve
cell membrane fluidity and function) and its relationship to vitamin D receptor
genetic polymorphisms (and the different functions and mediating effects that
vitamin D has for the specific biochemical and metabolic pathways involved with
each genetic polymorphism).
Comment: This is important research in humans suggesting
that not only should vitamin D levels be checked, but that higher levels may
suggest better functioning and long-term influences. Supplementation studies need to be done to confirm vitamin
D’s importance in cognition and what the optimal vitamin D level is for a range
of health conditions – there is definitely a lot to study and clarify. It is notable, however, that
these findings add to several studies suggesting that higher vitamin D levels
correlate with ‘better functioning’ and greater length of survival in cancer
patients. One study from Norway
found that higher levels of vitamin D were associated with longer survival in
breast, colon and lung cancer, as well as in lymphoma (Tretli S, et al, 2012).
Part of the importance
of vitamin D level, and optimal range and function is that vitamin D regulates
a significant amount (10-20 percent) of all genetic activity – it doesn’t get
much more essential to have an optimal level (not ‘normal range’ or deficient
level), so that more optimal functioning and health is achieved .
Health Coaching: The Effectiveness of Wellness Coaching for
Improving Quality of Life, Mayo Clinic Proc, Clark MM, et al. 2014 July 31
(Epub ahead of print)
Although this was a pilot study, it is important because
there are few published outcome studies showing the specific benefits of health
coaching, and this study showed benefits over a broad range of psychosocial
characteristics including depression, perceived stress and QOL. This research examined 100 employees
who participated in a 12-week wellness-coaching program - the primary outcome
measures that improved were QOL (five specific domains and overall QOL),
depressive symptoms and perceived stress.
Results showed significant improvements in all outcomes including QOL
(for all domains and overall, p<.0001), reduced level of depressive symptoms
(p<.0001) and reduced level of perceived stress (p<.001). These improvements were also then maintained
at the 24-week follow-up assessment suggesting some longer-term benefits.
This research was done to determine effect sizes for future
QOL and psychosocial outcomes studies so that future randomized controlled
trials (RCTs) can be effectively designed – the larger randomized studies are considered
level 1 evidence or really strong evidence. So these results helped to contribute to level 2 evidence for
health coaching benefits and set the stage for larger RCTs to be done, which I
am confident will show significant benefits and be cost effective.
Comment: As mentioned in the last newsletter, 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 lifestyle changes and health outcomes. Standardization in coaching
certification is being worked on and the fields of health coaching and
corporate wellness are evolving and growing so that it can become most
effectively utilized in healthcare settings. It is also notable that it had a
significant impact on perceived stress (in addition to depressive symptoms and
QOL), because my published article in cancer survivors suggested that perceived
stress correlates with many symptoms (eg. fatigue and pain) and QOL, so health
coaching (and other interventions such as mindfulness, meditation, yoga, tai
chi, and others) should be examined in cancer survivors for their ability to
impact perceived stress, a range of symptoms and QOL.
Integrative Medicine:
A Multimodal Intervention for Patients
with Secondary Progressive Multiple Sclerosis: Feasibility and Effect on
Fatigue, J Altern and Complement Med, Bisht B, et al. 2014;20:347-55.
For those of you who have seen the TED Talk by Terry Wahls,
MD and/or her book, The Wahls Protocol: How I beat progressive MS using Paleo
Principles and Functional Medicine (2014, Avery Publishing), this is an article
that describes some pilot study data based on her experience and recommendations. If you have not seen the TED talk, I highly
recommend it – it is an extraordinary story of a physician from Iowa who was
getting progressively worse with conventional or allopathic medical treatment,
and when she pursued other options such as a Paleo diet and functional medicine
(and other approaches), this led to a complete reversal and control of her
MS. It was actually fortunate that
she had gone to the Mayo Clinic to have her diagnosis confirmed because critics
and the conventional medical community would have claimed that she did not have
MS to begin with.
The pilot study followed 10 of 13 participants whose
adherence during a two week run-in phase was considered adequate, and then they
were followed for one year. The
intervention included a modified paleo diet, nutritional supplements,
stretching, strengthening exercises with electrical stimulation, meditation and
massage. In this small group the
fatigue scores significantly decreased (p<.001) and there were not any reported
side-effects suggesting that the protocol is safe. Future research is warranted for these natural and
integrative approaches to a chronic neurological disease such as MS.
Comment: It
has been interesting to see Terry Wahls describe and study an effective dietary
and functional medicine approach to progressive MS, since neurologists are
rarely open to integrative medicine and the potential benefit these approaches
can have on disease management and QOL.
It is also unfortunate that the protocol that was effective for Dr.
Wahls is being applied to everyone instead of understanding that this protocol
should be individualized to each participant or person with progressive
MS. An illustration of this is
that Terry Wahls has a food intolerance to eggs but that does not mean that
everyone does or that eggs should be excluded from the dietary program. However, this is still an important
advance in the consideration of dietary, nutritional and integrative medical
approaches for a chronic and complex disorder such as MS. In fact, in one interview Terry Wahls
reported that there were significant improvements for a few people who had
Parkinson’s disease and were following the protocol, and they suggest that it
could be beneficial for auto-immune diseases in general and well as other
neuropsychological conditions.
Cookbook
Recommendation: Kicking Cancer in
the Kitchen by Annette Ramke and Kendall Scott. Running Press Book Publishers, Philadelphia, 2012. This book is written by two cancer
survivors, whose ideas and recommendations may be helpful for all cancer
survivors because they share their experiences, challenges and insights on the
range of issues that they dealt with on their cancer journey. In addition, they provide a range of
healthy recipes for people to try so that they can add to their dietary recipe
collection and overall resources.
Update from Edman
Wellness Services:
My highlights and significant accomplishments from this
Summer were:
1.
Changing my company name – to Edman Wellness
Services from Edman Nutritional Services.
This reflects my expansion of services from nutrition and integrative
health to include health coaching, behavioral change and wellness promotion;
2.
I have begun to work with Business Health
Solutions, a corporate wellness company based in Baltimore – so far, I have
given talks to corporate clients but hope to expand to other clinical and/or
consulting activities in the near future;
3.
My first author article in the journal Integrative
Cancer Therapies was published in hardcopy in their September issue – it is
entitled, “Characteristics of Cancer Patients Presenting to an Integrative
Medicine Practice-Based Research Network.” It found that perceived stress
correlated with many physical and emotional factors, and should be measured and
addressed in all cancer patients in the course of their treatment and
post-treatment care. Again, if you
would like a copy of this, just send me an email and I will email it to you.
References
Relationship between 25-hydroxyvitamin D and cognitive
function in older adults: the Health, Aging and Body Composition Study. Wilson
VK, et al. J Am Geriatr Soc
2014;62:3839-53.
The Effectiveness of Wellness Coaching for Improving Quality
of Life, Mayo Clinic Proc, Clark MM, et al. 2014 July 31 (Epub ahead of print).
A Multimodal Intervention for Patients with Secondary
Progressive Multiple Sclerosis: Feasibility and Effect on Fatigue, J Altern and
Complement Med, Bisht B, et al. 2014;20:347-55.
Wahls T: “The Wahls Protocol: how I beat progressive MS
using Paleo principles and functional medicine. A radical new way to treat all chronic autoimmune
conditions.” New York: Avery,
Penguin Group, 2014.
Tretli S, et al.
Serum levels of 25-hydroxy vitamin D and survival in Norwegian patients
with cancer of the breast, colon, lung and lymphoma: a population-based
study. Cancer Causes
Control 2012;23:363-70.
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