by Gabriel Ariciu, DC
Over the weekend I found myself contemplating a lot on the subject of function and chronic disease. The wave of the future in healthcare is improving and optimizing function. Of course this raises a few of questions. What do I mean by function? How do we improve and optimize it? And how do we address chronic disease? The definition of function is instructive. It is “an activity or purpose natural to or intended fo a person or thing.” (1) Function has to do with what our body naturally does. We move, we eat, we live, and we are intended to enjoy this life. By improving function we improve the way nature has intended for us to live. But how do we improve it? I am going to address this in regards to chronic disease.
The CDC’s Chronic Disease Overview illustrates a striking picture. Consider the following:
- One in two Americans have one or more chronic diseases.
- One in four have two or more.
- Seven of the top 10 causes of death are from chronic disease.
- Almost 50% of those deaths resulting from heart disease and cancer. Obesity is at all time high.
- Arthritis has become the most common cause of disability. Diabetes is rampant and is the leading cause of kidney failure. Our risks for chronic diseases keeps growing.
- Almost 80% of people do not meet the recommendations for aerobic and muscle-strengthening physical activity.
- A study done in 2015 shows that 40% adults eat fruit less than once a day and 22% of adults eat vegetables less than once a day. Showing most people do not eat fruits and vegetables on a regular basis.
- 480,000 people die from cigarette smoking each year. Alcohol accounts for 88,000 deaths per year. And these statistics are for the US. (2)
The WHO states, “the burden of chronic diseases is rapidly increasing worldwide. It has been calculated that, in 2001, chronic diseases contributed approximately 60% of the 56.5 million total reported deaths in the world and approximately 46% of the global burden of disease. The proportion of the burden of NCDs is expected to increase to 57% by 2020. Almost half of the total chronic disease deaths are attributable to cardiovascular diseases; obesity and diabetes are also showing worrying trends, not only because they already affect a large proportion of the population, but also because they have started to appear earlier in life…It has been projected that by 2020, chronic diseases will account for almost three-quarters of all deaths worldwide, and that 71% of deaths due to ischaemic heart disease, 75% of deaths due to stroke, and 70% of deaths due to diabetes will occur in developing countries. The number of people in the developing world with diabetes will increase by more than 2.5 fold, from 84 million in 1995 to 228 million in 2025.” (3)
The cost is incredible. The CDC reports 86% of the US’s $2.7 trillion annual health care costs come from people with chronic and mental health issues. Cardiovascular diseases account for $316.1 billion and cancer accounts for $157 billion. Diabetes accounts for $245 billion. (2) It is an tremendous amount of money. But these costs can be drastically reduced.
Chronic diseases are not limited to the ones mentioned above it includes a wide variety of issues from autoimmune diseases to mental health to chronic infections. Rates of autoimmune disease have went up two to three-fold. We are plagued with chronic disease. It has become the norm. So what can be done? A paradigm shift is needed.
Typically, conventional medicine looks at an issue reductionistically. That is, they try to divide complex problems into its individual components. However, there are limitations to this approach. “When the human body is viewed as a collection of components, the natural inclination of medicine is to isolate the single factor that is most responsible for the observed behavior. Much like a mechanic who repairs a broken car by identifying that isolatable abnormality. Implicit within this practice is the deeply rooted belief that each disease has a potential singular target for medical treatment. For infection, the target is the pathogen; for cancer, it is the tumor; and for gastrointestinal bleeding, it is the bleeding vessel or ulcer.” (4) This approach has been successful, don’t get me wrong. If someone has a serious infection such as pneumonia, they receive antibiotic treatment that is life-saving. Acute cases are dealt with tremendous success. But with the chronically ill we hit the limitations. Especially when we consider that 85% of chronic disease is due to environmental factors like diet, toxin exposure, and lifestyle. (5)
Conventional medicine often relies on bringing the body to a balance. This is called homeostasis. If someone has high blood pressure they are given a blood pressure medication to reduce it. Often the underlying causative factor is ignored. Also being ignored is the effect the medication has on other systems of the body until a symptom presents itself. Maybe a different medication will be given or dosage may be modified. In addition to this a new medication may be given to counteract the effects of the blood pressure medication. This is done to help our body keep within what we consider normal ranges. Blood pressure for instance should be around 120/80. So the primary goal is to balance each component part but their relation to each other and their relation to each body system is often ignored. “The exclusive focus on normal ranges belies the importance of dynamic stability. Because reductionism often disregards the dynamic interactions between parts, the system is often depicted as a collection of static components.” (4) So each part is tackled one at a time individually. For example, hyperlipidemia and hypertension will be addressed separate from each other. Diseases are also treated in this fashion. Therefore, if you have diabetes and Hashimoto’s they will be addressed separately as two individual parts. This does make it easier to treat in an organized fashion however, the interplay between the two diseases is neglected. (4)
Reductionism is also used in our research. “The science underlying our medical practices, from diagnosis to treatment to prevention, is based on the assumption that information about individual parts is sufficient to explain the whole.” (4) This can be seen in studies that have shown a relationship between cholesterol and heart disease or saturated fats and cholesterol. You can read all about that in my cholesterol article. Suffice it say that addressing LDL cholesterol by lowering it with a medication neglects to answer many questions as well as the effect it has on the overall systems of the body. There are some definite negative effects but also like using a band aid it simply removes a symptom without addressing the causative factor. Reductionism has a hard time answering the questions of how diet and lifestyle contribute to a given disease. Therefore, a different approach is needed.
A Systems Approach
A systems approach views the body holistically rather than in it is individual component parts. The systems of the body are addressed with the understanding that they are interdependent to each other. “The intention of applying these theories to biological systems (termed “systems biology”) is to understand how properties emerge from the nonlinear interaction of multiple components. How does consciousness arise from the interactions between neurons? How do normal cellular functions such as cellular division, cell activation, differentiation, and apoptosis emerge from the interaction of genes? These questions highlight the difficulty of understanding complex biological systems—the moment the lens is directed toward the components of a biological system, the behaviors and properties of the whole system become obscure. Plainly said, one loses sight of the forest for the trees.” (4) We are in the business of looking at the forest as a whole while understanding how each tree works in regards to the forest.
There are several principles that guide this holistic approach.
- We believe that the body has the ability to heal and prevent most diseases. Hence we rely on supporting the body’s healing process via natural methods.
- Each person is biochemically unique and must be treated that way. This is called biochemical individuality. Therefore, the individual is treated not just the disease. Of course, this requires the practitioners to have in depth understanding of each of the body’s systems as well as biochemistry. We have to keep up to date and constantly evolving our approach as a deeper understanding develops. Hence, a evolving natural approach.
- Time. The average doctor’s visit is 10-12 minutes. It is very difficult to get to the underlying cause in that short period of time. We typically spend 30 to 60 minutes per patient.
- We improve and optimize function through diet, lifestyle, and behavior change.
Each of these principles guide us to diagnosing, treating, and addressing the needs of each patient.
Finally we make full circle back to function. Chronic disease represents our inability to function properly. Though we may like to think and we are often taught that there is nothing to be done with our disease state this is however, a falsehood. Genetic diseases account for less than 5% of all diseases. Our body is amazing at preventing and healing from disease. So by approaching each patient holistically we can improve function by helping them heal and preventing further disease. From there, we can strive for optimal function. As holistic practitioners we are well versed in doing this naturally and achieving amazing results. But there is one major caveat. This is something I have seen time and time again. We do our best to serve our patients but it is not a passive approach on the patient’s side. They must be active in their care. We encourage that strongly.
If improving and optimizing function is our goal, a patient will be required to change their diet, lifestyle, and behaviors. Otherwise, the desired results will NOT be achieved. It is so difficult to see patients who really want to improve, struggle with this aspect. There are a variety of reasons why this happens. Sometimes it may rely on the practitioner not explaining what changes need to be made, sometimes it is conditioning. We are all conditioned to live in a particular way. Our society typically eats a diet that lacks vital nutrition. We have grown accustomed to it. Our fast food, tv, movies, grocery stores, and behavior reflects this. Even to the point that we scoff at the idea of eating vegetables, fruits, organic, etc. Of course, there is a huge profit to made in the way things are ran but that is beside the point. Let’s turn our attention to idea of changing diet, lifestyle, and behavior. What do I mean by this? Why is it necessary?
Diet is essential. Hippocrates, the father of medicine, stated “Let food be thy medicine, and medicine be thy food.” There is a lot of truth in this. When we think of our body on a physiological level there are a lot of processes that work in congruence. Each process or pathway requires certain nutrients. These nutrients are broken up into two categories: macronutrients and micronutrients. We get our energy or fuel to run our body from our macronutrients. The macronutrients are carbohydrates, fats, and protein. Primarily we use carbohydrates and fats as fuel but to some extent we do use protein. The majority of protein is used as building blocks for maintenance of our body as well as for new tissue growth. Fats and carbs are also needed for building blocks too. This is an oversimplification. Vitamins, minerals, phytonutrients, fiber, etc. make up our micronutrients. We typically focus on vitamins and minerals though the others are important too. Vitamins such as vitamin A, D, and B vitamins (riboflavin, niacin, folate, etc.) help with a variety of our body’s processes. Minerals such as iodine, magnesium, and selenium do as well. Each of these nutrients go to help run specific processes throughout your body. For example, without selenium you cannot sufficiently turn T4 hormone into T3 hormone. T4 and T3 are thyroid hormones, T3 being the more active form. Without it your metabolism will be very sluggish. Another example is without niacin or methylfolate you cannot make dopamine, a much needed neurotransmitter. Of course, niacin and methylfolate are needed in a variety of other processes. Hopefully this illustrates my point well. We need nutrients. So we need a nutrient dense diet. A diet full of fresh, organic vegetables and fruits. Protein from grass-fed, pasture-raised animals. Fats from grass-fed butter, coconut oil, and avocados. Carbs from starchy vegetables such as sweet potatoes and fruit. Organ meat, vegetables, and fruits being the most nutrient dense foods we can eat. We need a variety and to eat them often to receive adequate nutrition.
Here is an example of how this plays out. A patient comes in complaining of depression and stomach problems. The practitioner finds a serotonin deficiency due to a lack of high quality protein and lack of methylfolate. Further, a gluten sensitivity is found resulting in leaky gut and dysbiosis. This creates a malabsorption issue and inflammation. A gluten free diet is recommended as well as some vitamin A to help heal the gut. As you can see this is a complex issue involving several systems. So the patient takes the supplements and even goes off gluten. A few weeks pass but they still do not feel good. The depression is somewhat better but the stomach problems persist. They are now wondering why that is. They ran out of methylfolate and vitamin A. The practitioner works on them again and finds they still need methylfolate and vitamin A. This cycle of visit to visit without the results continues. What is the problem? Why is this happening? It stems from a lack of nutrient dense diet and ridding the cupboards of processed sugars and food. The doctor and patient work together and the diet is changed. The patient then reports a resolution of their symptoms and they feel great! We can take supplements and they help prime the pump but in the end we need to eat a nutritious diet to help provide our body with the vital nutrients for it to function optimally.
That brings us to lifestyle and behavior. Changing or diet necessitates a lifestyle and behavior change. No longer are we shopping at the same places or eating out the same way. This is a process that must be eased into for most people. One step at a time is best. Diet is one factor, but we also need to move more often. We need to exercise and get out and walk. We need to run, jump, climb, hike, lift, and enjoy life. I think there is some preference here but the most important part is to move and move well. There is technique to it. These two changes ultimately change our behavior. We stop craving sugar. We want to strive for better health. Changing and living in a more natural way which promotes health and prevents disease.
Diet, lifestyle, and behavior modification is essential to the healing process. We are here for each step of the way and provide the necessary materials and assistance each individual may need. It is an active process but one that leads to long lasting results and optimal health. But maybe you do not have chronic disease. Maybe you just want to improve health or prevent disease. Prevention is key. Most of these illnesses take years to develop and jumping in early by trying optimize health is critical. Whatever your circumstances maybe, there is a tremendous amount of help out there, don’t give up.