When I started my practice in integrative medicine in 1978 there was no organized teaching about the impact that nutrition had on well-being and very little understanding of the connection between diet and disease. There were no road maps on how to practice nutritional medicine—the field was wide open for physicians like me to find a way to use diet to make a difference in people’s lives. Over the years, practicing this new type of medicine has brought its share of challenges but also incredible satisfaction and excitement.
One of the keys to practicing nutritional medicine is a physician’s willingness to suggest to people that they make significant dietary changes and utilize non-pharmaceutical approaches, including herbs, antioxidants, vitamins and minerals to help them recover from illness. Most importantly, the careful observation of the effect of these therapies and the feedback from my patients taught me what was useful and effective. Whenever I found significant improvement in symptoms like fatigue, joint and muscle pain, digestive problems, allergies, arthritis, headaches, or other conditions, either diagnosed or mysterious, I took notice. I wanted to understand why people got better, even if medical research could not explain these beneficial effects at the time.
In the 1980s, the field of psychoneuroimmunology revolutionized the understanding of the mind/body connection and provided a window into the connection between diet and changes in stress hormones. I realized that stress from poor dietary habits had a similar effect on the brain as did emotional and social stress. I began to research how diet and specific nutrients can improve the function of the brain as well as cortisol, the key hormone from the adrenal glands that influences metabolism and, ultimately, weight gain and risk for diabetes, heart disease, and cancer.
Recent breakthroughs further clarified the changes that can occur in the midbrain, the area of the brain that directly controls stress hormone secretions. Concepts such as allostasis and allostatic load describe how stress alters cortisol production and provide an understanding of why so many people have trouble recovering their health after stressful experiences and prolonged poor dietary habits. These ideas helped me to appreciate the widespread effect of stress on my patients’ symptoms and led me to focus on methods to improve adaptation. This new information further refined my approach with patients and led to the information in this book.
In the past couple of years, one issue has become increasingly critical for the health of the world’s population: obesity. In a study that looked at population data from 106 countries, Kelly and colleagues (2008) reported that if present trends continue, by the year 2030 there will be more than 2.16 billion overweight and 1.2 billion obese people in the world, many of whom will suffer from cortisol-driven disease. One aspect of the obesity epidemic that has received little attention in the popular press and is extensively discussed in this book is epigenetics, which describes the effect that diet and environmental toxins have on the gene expression that controls all cell function and is linked to weight gain and overall health. The book also contains important new information on the connection between cortisol and obesity and the importance of maintaining healthy gut bacteria (microbiota) to prevent diabetes and to lose weight, including key nutrients needed for the gut bacteria to thrive. In addition, the latest research on the key brain-protecting nutrients is detailed.
Findings from the emerging field of epigenetics will have a dramatic effect on the practice of medicine in the future. Epigenetics describes heritable changes in gene expression—passed from generation to generation of cells and at times from parents to children—influenced by diet and environmental toxins. Epigenetic studies (more than sixteen thousand research articles are published every year) also show the beneficial effect of certain foods (bioactive foods) and dietary practices on normalizing gene expression, reducing the risk for obesity, cancer, diabetes, and many other diseases. The bioactive foods include curcumin from turmeric, sulforaphane from broccoli, green tea, and genistein from soy. Epigenetic research has also identified specific deficiencies in the diet, such as lack of folic acid that can lead to increased risk of abnormal gene expression and obesity. These findings add another dimension to The Adaptation Diet program designed to control cortisol, lose weight, and prevent chronic disease.
In addition, common pollutants including polychlorinated biphenyls (PCBs), bisphenol A, and mercury, to name a few, greatly impact gene expression and increase the risk for obesity and cancer. A group of chemicals called persistent organic pollutants (POPs) include several toxins that are termed obesogens because of their dramatic effect on weight gain. Reducing exposure to these toxicants provides an additional tool in protecting the genome and maintaining normal weight, adaptation and high-level wellness.
In today’s stressful climate, everyone needs to reduce stress in the areas that they can control. The place to start is at the dinner table.
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