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Description: In This Issue: CAM Forecast 2015, Cardiovascular Health, Patient Compliance, Joint Health

HE www.naturalpractitionermag.com January February 2015 AL THE VIS TH IN IT U BO CAR TEG S A OT E S RA T H Y TI 1 MP VE 10 OS 0 IU M A VRM Media Publication Go to naturalpractitionermag.com quintron for info about this advertiser Go to naturalpractitionermag.com americasfinest for info about this advertiser TABLE OF CONTENTS January February 2015 VOLUME 4 NO. 1 18 FEATURES 18 CAM Forecast 2015 Practitioners discuss the future of complementary and alternative medicine. 21 8 COLUMNS 4 Editor s Note 8 Practitioner Corner 27 Product Focus Joint Health 21 Keeping Hearts Beating Strong Integrative practitioners can help turn tables on cardiovascular disease. 24 Developing Patient Adherence Practitioners can lead their patients to the water of therapeutic compliance and make them drink. DEPARTMENTS 12 Health News 29 Monograph Garlic 32 Practitioner Chat 34 Natural Health Studies 38 Natural Marketplace 39 Bookshelf 40 Conferences & Events 40 Advertiser Index Visit NaturalPractitionerMag.com FreeProductInfo for FREE Product Information or Samples from All Natural Practitioner Advertisers FREE Subscription (Print Digital or BOTH) FREE E-newsletter Visit NaturalPractitionerMag.com Copyright 2015. Natural Practitioner (ISSN 2331-2580) Volume 4 Number 1 January February 2015. Natural Practitioner is published monthly (except for bimonthly January February March April June July and September October) by Vitamin Retailer Magazine Inc. 431 Cranbury Road Suite C East Brunswick NJ 08816 USA Phone (732) 432-9600 Fax (732) 432-9288. All rights reserved including the right to reproduce in whole or in part. Not responsible for unsolicited material. Opinions expressed in by-lined articles or advertisements are not necessarily those of Natural Practitioner or its owners. Publisher is not liable for advertiser product claims or representations. Advertisers assume total responsibility for the contents of their advertisements. No portion of this magazine is intended to diagnose treat cure or prevent any disease. Printed in U.S.A. Basic annual subscription rate is 50.00. POSTMASTER Send address changes to Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246. Subscription Customer Service Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246 USA Phone (818) 286-3169 Fax (800) 869-0040 nprcs magserv.com www.naturalpractitionermag.com. Back Issues & Single Copies For order information contact (732) 432-9600 or info naturalpractitionermag.com. December issue is 25.00. All other issues are 10.00 each. 2 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Go to naturalpractitionermag.com xlear for info about this advertiser EDITOR S NOTE What Lies Ahead et s be honest. We d all like to have a crystal ball that we can pull out at a moment s notice gaze into fondly and find out what the future holds. The same is true of course for alternative complementary and integrative health care professionals as we turn the calendar to a New Year. For many of us 2015 holds the promise of continued growth for natural medicine and your practices as consumers especially the aging Baby Boomer generation search for answers on how to best take control of their own health care naturally in their golden years. As this trend continues the potential for collaboration between more conventional medicine and natural medicine seems a no-brainer with many health care practitioners beginning to implement natural remedies into their patients regimens. This brings us to the focus of our first Natural Practitioner (NP) issue of the New Year where we have convened a panel of experts who provide their insights and predictions into what lies ahead for CAM professionals and provides tips and advice into what your practice may need to stay ahead of the game in order for you to continue to provide the best care for your patients. Here our experts provide their insights into the current state of the CAM industry and make predictions as to how that CAM model might change in the year ahead while identifying what opportunities may exist for your practice moving forward. They also talk about the adjustments practitioners like yourself must make in order to continue to grow your business. This enlightening roundtable discussion however is only our leadoff batter in what is a great lineup of editorial features to help kick off our fourth year of NP in publication. L Though the advice of our outstanding Editorial Advisory Board which I am thrilled to announce remains in tact for 2015 this issue also includes a feature on the importance of patient compliance and adherence. As you know one of the toughest challenges practitioners face is having their patients adhere to their treatment plans and regimens. Many times in the case of natural remedies patients are searching for the magic bullet. Read about what factors come into play here and discover tips from experts on how practitioners can work with their patients to help achieve better compliance and adherence which in turn leads to better patient outcomes. Our initial offering for 2015 also tackles the all-important topic of cardiovascular health as we celebrate American Heart Month in February where we take a closer look and how integrative and alternative practitioners can offer viable solutions for patients including diet lifestyle modifications and supplements. I also wanted to remind you to please visit our newly updated website at www.naturalpractitionermag.com where you will find the latest news features and product information for your practice. As always we encourage your feedback as to how we can improve our offerings to better serve you and your practice. Finally NP will again be exhibiting at the Integrative Healthcare Symposium in New York City in mid-February. Please stop by our booth and say hello between sessions to pick up the latest copy of NP and learn more about ways you can contribute to our publication. I look forward to speaking with you soon. PUBLISHER DANIEL MCSWEENEY EDITORIAL DIRECTOR DanM VRMmedia.com ASSOCIATE PUBLISHER RUSS FIELDS RussF VRMmedia.com ADVERTISING ROY KIEFFER SALES MANAGER RoyK VRMmedia.com ADVERTISING GARY PFAFF SALES ASSOCIATE GaryP VRMmedia.com INDEPENDENT GLENN DULBERG SALES REPRESENTATIVE GlennD VRMmedia.com EDITOR-IN-CHIEF DANIEL BREEMAN DanielB VRMmedia.com MANAGING EDITOR SHARI BARBANEL ShariB VRMmedia.com ASSISTANT EDITOR CRISTINA GOODWIN CristinaG VRMmedia.com CONTRIBUTING EDITOR JANET POVEROMO JanetP VRMmedia.com ART DIRECTOR ROBERT CERTO PRODUCTION MANAGER RobertC VRMmedia.com PRODUCTION ASSISTANT BRYAN ZAK GRAPHIC ARTIST BryanZ VRMmedia.com CIRCULATION MANAGER YOKO MCSWEENEY General VRMmedia.com VRM MEDIA 431 Cranbury Road Ste. C East Brunswick NJ 08816 PHONE (732) 432-9600 FAX (732) 432-9288 E-MAIL info VRMmedia.com WEBSITE www.naturalpractitionermag.com PRESIDENT DANIEL MCSWEENEY DanM VRMmedia.com MISSION STATEMENT Natural Practitioner magazine provides alternative complementary and integrative health care professionals information about natural products market trends industry news health research and other content designed to benefit their practices and improve their business results. Subscription Customer Service To order a subscription or manage your account please contact us at Natural Practitioner P.O. Box 15246 North Hollywood CA 91615-5246 USA Phone (818) 286-3169 Fax (800) 869-0040 nprcs magserv.com www.naturalpractitionermag.com Back Issues See the Table of Contents page for price and order information. 4 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Go to naturalpractitionermag.com davinci for info about this advertiser Meet Natural Practitioner s Editorial Advisory Board Adam Killpartrick DC Dr. Adam Killpartrick earned his degree from Palmer College of Chiropractic in Davenport IA. His primary practice focus has been a synergistic blend of NUCCA (upper cervical chiropractic) with Cranial Release Technique for which he has attained lead instructor status. Dr. Killpartrick furthered his education in clinical nutrition functional diagnostics and lifestyle medicine and has since successfully integrated this blend of specialized chiropractic care and functional medicine into his New Hampshire private practice. This practical experience led him to clinical consulting for numerous nutritional supplement companies. He is currently the director of product development for Innate Response formulas where he and his team are responsible for product formulation educational material technical support clinical program development and product application as it relates to clinical practice. In its search to provide readers with insight and perspective that will help them build and better their practices Natural Practitioner has culled together an Editorial Advisory Board of authoritative practitioners willing to do just that. You will see our Board members present in key editorial as well as each authoring their own column Practitioner Corner throughout the year that highlights their expertise and professional experiences. They will also lend us their perspective on trends and topics that Natural Practitioner will be covering in issues to come. Natural Practitioner s Editorial Advisory Board is comprised of Walter J. Crinnion ND After receiving his naturopathic medicine degree from Bastyr University in 1982 Dr. Walter J. Crinnion opened a family practice and began specializing in allergies and treating chronic health problems caused by environmental chemical overload leading him to open Healing Naturally the most comprehensive cleansing facility for chemically poisoned individuals in North America in 1985. A frequent lecturer he has published several articles in peer-reviewed journals in addition to his book Clean Green and Lean. Dr. Crinnion has been on the board of directors of the American Association of Naturopathic Physicians and is a two-time recipient of their award for in-office research. Having taught at Bastyr the National College of Naturopathic Medicine and the University of Bridgeport School of Naturopathic Medicine he is currently a professor at the Southwest College of Naturopathic Medicine and the chair of its Environmental Medicine Department. Holly Lucille ND Dr. Holly Lucille is a nationally recognized licensed naturopathic physician lecturer educator and author of Creating and Maintaining Balance A Women s Guide to Safe Natural Hormone Health. Her private practice Healing from Within Healthcare focuses on comprehensive naturopathic medicine and individualized care. Outside of her practice Dr. Lucille holds a position on the American Association of Naturopathic Physicians board of directors and is on the faculty of the Global Medicine Education Foundation. She is the past president of the California Naturopathic Doctors Association where she spearheaded a lobbying effort to have naturopathic doctors licensed in the state of California. A graduate from the Southwest College of Naturopathic Medicine Dr. Lucille s commitment to naturopathic medicine has been recognized with the Daphne Blayden Award and more recently the SCNM Legacy Award. Jared M. Skowron ND Dr. Jared M. Skowron is a national expert in natural medicine for children. Author of the best-selling 100 Natural Remedies For Your Child his life s work is dedicated to the optimal health of children. A faculty member at University of Bridgeport and founder of their Pediatric & Autism Clinic Dr. Skowron has helped thousands of children fulfill their optimal potential. He is vice president of the Pediatric Association of Naturopathic Physicians and his expertise is in pediatrics autism ADHD and acute and chronic EENT conditions. Shailinder Sodhi ND Growing up near the Himalayas Dr. Shailinder Sodhi developed an early interest in ayurvedic plants and herbs and received his BAMS (bachelor in ayurvedic medicine and surgery) degree from Dayanand Ayurvedic College in Jalandhar India in 1985. In 1993 he received a naturopathic medicine degree from Bastyr University as well as a degree in diagnostic ultrasound from Bellevue College. Dr. Sodhi practices naturopathic medicine along with his wife Dr. Anju Sodhi and his brother Dr. Virender Sodhi at the Ayurvedic and Naturopathic Medical Clinic in Bellevue WA which he established in 1989. In addition Dr. Sodhi serves as president of Ayush Herbs Inc. a manufacturer of high-quality ayurvedic herbal formulas is an adjunct faculty member at Bastyr and has been published in several natural health magazines. Jacob Teitelbaum MD A recognized authority on chronic fatigue syndrome (CFS) and fibromyalgia Dr. Jacob Teitelbaum is medical director of the Fibromyalgia and Fatigue Centers nationally and does phone consultations with CFS fibromyalgia patients worldwide. He is the author of the popular iPhone application Cures A-Z and author of the best-selling book From Fatigued to Fantastic (3rd revised edition Avery Penguin Group) and Pain Free 1-23--A Proven Program for Eliminating Chronic Pain Now (McGraw-Hill). His newest book is Beat Sugar Addiction NOW (Fairwinds Press 2010). Dr. Teitelbaum does frequent media appearances including Good Morning America CNN Fox News Channel the Dr. Oz Show and Oprah & Friends. Amber Lynn Vitse BA LMT CN Amber Lynn Vitse BA LMT CN majored in economics with postgraduate work in medical sciences and additional certifications in bodywork and nutrition. She is the founder and principal of AmberLynnVitale an independent producer and presenter of unique media content designed to educate the public and the medical establishment on current health trends and ethical and legislative concerns. A leading edge provider and educator of Fusion Bodyworks she practices an integrated modality of ayurvedic medicine yoga advanced bodywork and holistic nutrition. Vitse uses her 17 years of experience in integrative medical practices to provide consultation on marketing to the consumer mindset. She recently joined the Garden of Life team as their Northeast Educator. Deborah Waddell Dipl Ac LAc Nationally licensed through the National Commission of Chinese and Oriental Medicine (NCCAOM) Deborah Waddell has served on the faculty of The Eastern School of Acupuncture she is a member of the American Pregnancy Association and is currently obtaining her Plant Based Nutrition Certification from Cornell University. The founder of Skyland s Acupuncture & Wellness Center specializing in pain facial rejuvenation women s health and fertility optimization Waddell also educates her patients and the community through seminars on the virtues of a plant-based diet for optimal and preventive health. Through the use of acupuncture Chinese herbal formulas dietary therapy and mind-body techniques she has helped women realize their dream of having a family naturally. 6 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Go to naturalpractitionermag.com carlson for info about this advertiser PRACTITIONER CORNER The Aluminum Alzheimer s Autism Connection By Dr. Jared M. Skowron onfusion of the mind confusion of ideas and thoughts personal identity is confused mistakes in speaking using words not intended confusion of the intellect... Dementia speech alterations myoclonias asterixis and convulsions. What does this describe What comes to mind Alzheimer s Autism Last New Year s Eve party In actuality the first quote is a description of people with aluminum poisoning from Kent s Homeopathic lectures. The second is the standard medical definition of aluminum poisoning in kidney failure patients on dialysis. Aluminum causes brain damage. Period. In fact pharmaceutical research studies on Alzheimer s medications are performed on mice that are injected with aluminum to give them the brain damage to mimic Alzheimer s so that the drugs can be tested accurately. Children fed formula with aluminum versus aluminumfree formula score lower on mental devel- C opment tests.1 People accidentally exposed to high levels of aluminum contract memory loss fatigue depression behavioral changes and learning impairment.2 Aluminum causes brain damage. Period. So if aluminum causes brain damage and it is scientifically proven beyond a doubt why do we still ingest it Why is it still in your antacids your buffered aspirin and your vaccines The answer is dose-dependent. How much are you ingesting versus how much are you excreting in your urine What remains is what causes the brain damage. Aluminum is everywhere. It is the third most abundant mineral in the Earth s crust. It s in your water it s in your food and our bodies have become accustomed to that level of aluminum through evolution (thanks Darwin). Our GI (gastrointestinal) absorption of aluminum is negligible in its natural form (approximately 0.1-0.4 percent). Skin absorption is also minimal (aluminum in anti-perspirants is negligible). The problem comes when our industries concentrate toxic substances change their form and feed them to us without performing adequate safety studies. In fact the CDC (Centers for Disease Control and Prevention) acknowledges that the safety of aluminum is assumed and has not been tested completely.3 So what do we do How do you avoid toxic levels of aluminum Answer Avoid the top three sources of aluminum Interestingly enough let s look at our two major conditions that are potentially caused by aluminum. Alzheimer s Highest levels of aluminum are found in antacids and buffered aspirin. Who takes these for reflux and clot prevention--the geriatric population Who is the most susceptible to Alzheimer s--You guessed it Autism High concentrations of aluminum are found in some vaccines. When reading safety literature on vaccines it will clearly state the safety of orally ingested aluminum. Safety and toxicity research on injected aluminum has not 8 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Go to naturalpractitionermag.com mushroomwisdom for info about this advertiser PRACTITIONER CORNER been performed on children It has been performed on animals and it always causes brain damage.2-6 While the amount of injected aluminum is small ( 0.85mg dose) so are these kids Tiny 6-pound children at birth are being injected with a hepatitis B vaccine loaded with aluminum. What do you think that does to a developing brain A few months later Hib DTaP pneumococcus hep A Polio are all vaccines that can contain aluminum. Everything that is injected enters the body. Do not be confused by the low absorption rate of orally ingested aluminum. Injected aluminum is absorbed 100 percent and is known to damage the brain more than any other part of the body. In fact the half-life of aluminum in your brain can be up to 50 years.4 You don t want yourself or your family to get Alzheimer s or autism so what can you do First prevent. Stop antacids and buffered aspirin and use aluminum-free vaccines. Second detoxify the aluminum that is currently in your body. Only a small amount of research has been performed on aluminum detoxification. The best options are substances with high silicon content. Also consider DFO (physician monitored only) EDTA (physician monitored only) and NAC. Curcumin has been shown to reverse aluminum-induced toxicity.5 It s a dirty world out there and we can t live in a bubble. Unfortunately sometimes business profits have a higher priority than consumer safety (i.e. Vioxx). Here s your action plan. Accept aluminum causes brain damage. Believe it may be a contributing factor to Alzheimer s and autism. Avoid antacids buffered aspirin and aluminum containing vaccines. Push for more research on aluminum toxicity and treatment. Continue to fight for your family and friends. Every health condition has a cause nothing is idiopathic and keep your hope We will find an answer. References 1 Toxicology Profile for Aluminum US Dept Health and Human Services Sept 2008. 2 Shaw CA1 Li Y Tomljenovic L. Administration of aluminum to neonatal mice in vaccine-relevant amounts is associated with adverse long-term neurological outcomes. J Inorg Biochem. 2013 Nov 128 237-44. doi 10.1016 j.jinorgbio.2013.07.022. 3 Shaw CA1 Tomljenovic L. Aluminum in the central nervous system (CNS) toxicity in humans and animals vaccine adjuvants and autoimmunity. Immunol Res. 2013 Jul 56(2-3) 304-16. doi 10.1007 s12026-013-8403-1. 4 Yasuda H1 Yasuda Y Tsutsui T. Estimation of autistic children by metallomics analysis. Sci Rep. 2013 3 1199. doi 10.1038 srep01199. 5 Blaurock-Busch E1 Amin OR Dessoki HH Rabah T. Toxic Metals and Essential Elements in Hair and Severity of Symptoms among Children with Autism. Maedica (Buchar). 2012 Jan 7(1) 38-48. 6 Tomljenovic L1 Shaw CA. Do aluminum vaccine adjuvants contribute to the rising prevalence of autism J Inorg Biochem. 2011 Nov 105(11) 1489-99. doi 10.1016 j.jinorgbio.2011.08.008. Dr. Jared M. Skowron is the Amazon bestselling author of 100 Natural Remedies For Your Child an international speaker on natural medicine and on the Advisory Board of Autism Hope Alliance. He is the founder of www.spectrumawakening.com offering answers to children on the autism spectrum. Dr. Skowron has a private practice in Connecticut and enjoys over a decade of helping children feel happier and healthier. 10 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Go to naturalpractitionermag.com probioticsinternational for info about this advertiser HEALTH INDUSTRY NEWS VRM Media Acquires Fitness Trainer Magazine V RM Media (East Brunswick NJ) a leading provider of business magazines websites and e-newsletters for the health and natural products industry has announced its acquisition of Fitness Trainer magazine from the Mallarina Sales Corporation. Fitness Trainer founded in 2012 by Robert B. Rose is a digital business magazine for personal trainers and other professionals within the 78 billion global fitness and health club industry. The magazine is distributed on a six-time per year basis to more than 90 000 personal trainers plus bonus distribution to more than 100 000 active fitness consumers including top athletes coaches physical therapists and nutritionists. We are thrilled to welcome Fitness Trainer into the VRM Media family of health and wellness business publications said Daniel McSweeney president of VRM. Fitness Trainer is the No. 1 business magazine for personal trainers and with its focus on health and fitness is a perfect addition to VRM s existing portfolio which includes Vitamin Retailer Nutrition Industry Executive and Natural Practitioner. Fitness Trainer is at the forefront of today s publishing industry technology with its digital interface providing a number of unique and beneficial user tools McSweeney added. Also readers and advertisers are able to immediately connect with just a click of a mouse or tap of a finger. VRM announced that Rose will continue to oversee the publication as consulting editor working alongside current Editorin-Chief Amy Kierce and Graphic Designer Jesse Radford. The magazine s advertising sales efforts will now be directed by VRM s Roy Kieffer assisted by Russ Fields and Gary Pfaff. Fitness Trainer grew in popularity beyond my imagination in just two years noted Rose. In order for it to reach the next plateau a full staff of professionals was needed and VRM was a perfect fit in every way. I am pleased to join the VRM team and to continue to help produce Fitness Trainer for the benefit of our many loyal readers and advertisers. Fitness Trainer is for trainers by trainers with articles written by worldrenowned fitness experts including regular contributions from leading certification and training organizations such as the National Strength and Conditioning Association the National Council for Certified Personal Trainers the International Association of Resistance Trainers and the National Academy of Sports Medicine. For more information visit www.fitnesstrainermag.com or www.vrmmedia.com. President Obama Signs Sunscreen Innovation Act n November 26 President Obama sign the Sunscreen Innovation Act (SIA) into law after is was passed in the House of Representatives on November 14. The bill is designed to address a regulatory backlog that is preventing U.S. consumers from having access to advanced effective sunscreens that are widely available in the rest of the world. The U.S. Senate passed the bill in September. SIA will help the U.S. catch up to other countries in sunscreen technology by expediting the U.S. Food and Drug Administration s (FDA) review process for active ingredients in sunscreens that have long been approved for use in places like Europe and Canada. Some of these sunscreen ingredients have been safely used overseas for years but have had their applications pending before the FDA for more than a decade. SIA also seeks to shed some light on the FDA s review process by requiring the agency to periodically report to Congress on the progress of this effort. The signing of the Sunscreen Innovation Act by President Barack O Obama is the culmination of persistent bipartisan work by Congress and stakeholders to provide Americans with access to the latest sunscreen products to help curb future cases of skin cancer particularly melanoma said Michael Werner Public Access to SunScreens (PASS) Coalition policy advisor. We are confident that the new law will enable Americans to have greater choice when it comes to protecting their skin from the sun s harmful UVA and UVB rays. Skin cancer is the most common form of cancer diagnosed in the U.S. Each year there are more new cases of skin cancer--including melanoma--than the combined incidence of breast cancer prostate cancer lung cancer and colon cancer. On average one person dies every hour from melanoma the deadliest of the skin cancers because of its ability to move quickly and spread to distant organs in the body and melanoma rates are rising dramatically across demographics. Over the past 40 years melanoma rates have increased 800 percent among young women and 400 percent among young men. The last over-the-counter (OTC) sunscreen ingredient to be approved by FDA was in the 1990s. Since 2002 eight new sunscreen applications have been filed and are still awaiting review 12 years later. With President Obama s approval of the bipartisan SIA FDA must now work with applicants Congress and stakeholders to implement the new law. FDA must render a decision on the eight pending sunscreen application according to statutory timelines created by the legislation with some decisions expected as quickly as six months from enactment. The President s approval of the Sunscreen Innovation Act demonstrates that the White House and Congress agree that FDA should ensure all sunscreens receive a transparent review within a predictable timeframe Werner said. With this law Congress has helped answer the U.S. Surgeon General s Call to Action to Prevent Skin Cancer. The PASS Coalition and other stakeholders will now focus on working with FDA to guarantee the new law is implemented as quickly as possible. 12 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Healthy Nation Coalition Details Persistent Failures of DGA I n an open letter to government officials the Healthy Nation Coalition described the Dietary Guidelines for Americans (DGA) as a failed policy. The letter from concerned scientists nutrition professionals and consumers is addressed to the Secretaries of the U.S. Departments of Agriculture and Health and Human Services. The letter asserts that these recommendations contribute to worsening health outcomes for the nation and should be replaced with guidance focused on essential nutrition (see full text and downloadable PDF at http forahealthynation.org healthy-nationcoalition-letter .) On December 15 2014 the 2015 Dietary Guidelines Advisory Committee which reviews the DGA finished deliberations. The committee is expected to issue guidelines perpetuating 35 years of advising consumers to reduce their intake of eggs meat and full-fat dairy. While the consumption of these foods has decreased in past decades rates of obesity have doubled and rates of diabetes have tripled. Critics maintain the DGA which directs all federal nutrition activities are not sufficiently grounded in science not compatible with adequate essential nutrition and do not respect the diversity of food traditions in America. The narrow focus on plantbased nutrition ignores unique dietary needs of growing children older adults athletes and ethnic minorities. Furthermore this focus has prevented federally-funded research into dietary approaches not in line with the DGA including the use of low-carbohydrate diets to treat diabetes. More than 70 clinicians and academics have joined farmers and ranchers as part of the 600 signatories to the letter. These include several notable voices on nutrition Robert Lustig MD of the University of California Paul Jaminet PhD author of The Perfect Health Diet Mark Sisson blogger and author of numerous books on fitness and health Richard Feinman PhD of SUNY Downstate Medical Center Sean Lucan MD of Albert Einstein College of Medicine and co-author of textbooks on nutrition and public health and Sally Fallon Morell founder of the nutrition education nonprofit The Weston A. Price Foundation. Spokesperson for the coalition is Adele Hite a registered dietitian PhD student at North Carolina State University and former health educator at Duke Lifestyle Medicine Clinic. Our way forward doesn t have to emphasize dietary extremes she explained. We propose recommendations that provide clear concise food-based guidance that helps Americans meet essential nutrition needs according to their own food traditions. We cannot justify guidelines that restrict nutritious whole foods like meat eggs and butter discriminate against farmers who produce them and confound efforts of Americans who recognize their health benefits. For more information visit www.forahealthynation.org. Go to naturalpractitionermag.com emerson for info about this advertiser JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 13 HEALTH INDUSTRY NEWS NCNM Provost Dr. Andrea Smith Elected to Serve ACAOM T he Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) announced that Andrea C. Smith EdD was elected as an academic member of the Commission. The appointment of Dr. Smith provost and vice president of Academics Affairs at National College of Natural Medicine (NCNM) is effective immediately. ACAOM is recognized by the U.S. Department of Education as a specialized and professional accrediting agency. ACAOM s primary purposes are to establish comprehensive educational and institutional requirements for acupuncture and Oriental medicine programs and to accredit programs and institutions that meet these requirements. ACAOM currently has more than 60 schools and colleges with accreditation or candidacy status. During her 22-year tenure at NCNM Dr. Smith has held many senior administrative positions including dean of Institutional Research and Assessment dean of the School of Classical Chinese Medicine dean of Student Services and educational consultant. As provost Dr. Smith has presided over a growing number of academic programs while continuously raising the bar on academic standards at NCNM. Dr. Smith who holds a doctorate in education in curriculum and instruction from Portland State University presently oversees six doctorate and master s degree programs in NCNM s Schools of Naturopathic Medicine Classical Chinese Medicine and Research and Graduate Studies the departments of Student Life and Institutional Research and Compliance the Helfgott Research Institute and NCNM Library and the offices of the chief medical officer and the dean of Academic Progress. In announcing Dr. Smith s appointment as a new Commissioner ACAOM Chair Catherine Niemic JD LAc expressed her delight in having Smith join the organization noting that Dr. Smith brings a depth of experience and knowledge to the Commission that is of great value as ACAOM continues to provide the highest quality of accreditation services while preparing for the future of the profession. Dr. Smith has long been active in the acupuncture and Oriental medicine educational community including her work with the Council of Colleges of Acupuncture and Oriental Medicine and ACAOM s task forces for its first professional doctorate which was announced in 2013 and its current re-conceptualized master s programs. For more information visit www.acaom.org or www.ncnm.edu. Cell Science Systems Launches Affordable Telomere Testing ell Science Systems Corp. (Deerfield Beach FL) one of the very few labs to offer telomere length testing has launched its new version of this test at an affordable price. Knowing C your telomere length is important because it directly relates to health and longevity. Telomere length testing has recently become of wider interest following a study at FAMILY OF PUBLICATIONS www.VitaminRetailer.com 20 Y ars Celebratingellence e of Exc Branch Out and Join VRM Media s www.GlutenFreeRetailer.com 1995 2015 www.NaturalPractitionerMag.com www.NIEmagazine.com www.FitnessTrainerMag.com Contact One of Our Ad Specialists Today Russ Fields at 732-432-9600 ext. 102 or e-Mail RussF VRMmedia.com Roy Kieffer at 719-358-9838 or e-Mail RoyK VRMmedia.com Gary Pfaff at 732-432-9600 ext. 107 or e-Mail GaryP VRMmedia.com Brigham and Women s Hospital published in the British Medical Journal. In the study Mediterranean diet and telomere length in Nurses Health Study population based cohort study researchers analyzed 4 676 disease-free women who had their telomeres measured and completed biennial food frequency questionnaires. They found that women who follow the Mediterranean diet rich in vegetables fruits nuts legumes and unrefined grains had longer telomere length. Longer telomere length is usually associated with greater health and longevity. Telomeres are repetitive non-encoding DNA sequences at the ends of chromosomes that get shorter each time a cell divides. They are analogous to the plastic tips on shoelaces and protect the DNA that gets copied. Shorter telomeres are associated with a decreased life expectancy and increased rate of aging-related disease. What do you do if your telomeres are not as long as you d like Cell Science Systems is also well known for its proprietary method of food and chemical sensitivity testing--the Alcat Test. Food and chemical sensitivities have been linked to inflammatory processes and inflammatory processes shorten telomeres. This research supports our view that diet plays a critical role in overall health and aging. Combining the Alcat Food Sensitivity Test with Telomere Length testing is a perfect marriage said David Blyweiss MD MPH chief medical officer for Cell Science Systems. The Alcat blood test can help determine which foods and other substances may trigger unwanted inflammation which accelerates telomere attrition. For more information call (800) US-ALCAT or visit www.alcat.com. 14 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Go to naturalpractitionermag.com charak for info about this advertiser HEALTH INDUSTRY NEWS Vitamin D Council Introduces In-home Vitamin D Test Kit I t is estimated that 40 to 75 percent of all Americans are deficient in vitamin D which has been linked to an increased risk to Alzheimer s cancer cardiovascular autoimmune and other diseases. To help bring awareness and to test individual vitamin D levels the Vitamin D Council has announced the release of vitamin D test kits that can be completed from the comfort of home. The kit is the most affordable vitamin D kit on the market and is now available for shipping nationwide. Vitamin D is vitally important and is essential for calcium consumption bone health and virtually all human organs. Vitamin D deficiencies have been associated with a variety of diseases from cardiovascular disease childhood asthma multiple sclerosis cancer and cognitive impairment in the elderly. Vitamin D deficiency is of more concern during the winter months when people are unable to make as much vitamin D from the sun. Symptoms of vitamin D deficiency include bone pain muscle weakness chronic fatigue and impaired balance among others. Even without symptoms too little vitamin D poses health risks. The Vitamin D Council s mission is to educate the public and health care providers on the importance of vitamin D and to help reduce the global burden of vitamin D deficiency. The new test kits mark a major leap forward for the Council and provides a servicebased approach to helping combat vitamin D deficiency. It estimated that 40 percent of the American population is deficient in vitamin D said John Cannell MD executive director of Vitamin D Council. This convenient test kit will have a large impact and help reduce the burden of this pandemic. The new test kit is the most affordable test kit of its kind currently available in the United States 50 for a single kit and 180 for a kit for a family of four. Kits can be ordered from www.vitamindcouncil.org testkit. All that is required to test is a few drops of blood on the spot card provided which is then shipped to the Council s partnering lab Heartland Assays. Heartland Assays a company that provides testing for many large academic studies uses the highly accurate LC MS MS technique to determine vitamin D levels. Within one to two weeks results are conveniently uploaded to a secure webpage which can only be accessed by the customer s private account information. For more information visit www.vitamindcouncil.org. Dr. Rita Bettenburg Receives Living Legend Award from NCNM and OANP he National College of Natural Medicine (NCNM) and the Oregon Association of Naturopathic Physicians (OANP) recently honored Rita Bettenburg ND with the organizations highest honor the 2014 Living Legend award. The award was conferred at a banquet held December 6 2014 at the Portland Marriott Downtown Waterfront Hotel. The award recognized Dr. Bettenburg s outstanding leadership commitment to excellence and longstanding contributions toward the advancement of the naturopathic profession in Oregon. What distinguished Dr. Bettenburg from other nominees is the extraordinary breadth of how she has served the profession commented Laura Culberson Farr executive director of the OANP during the presentation of the award. From teaching to advocacy to accreditation at the state and the national level Dr. Bettenburg has been there for 25 years. Dr. Bettenburg s dedication to deepen and expand the scope of practice of naturopathic medicine ran parallel to her commitment to raising the standards of medical education for naturopathic physicians. T After earning a Master of Science in Medical Technology in 1974 from the University of Minnesota Dr. Bettenburg launched what would become a nearly 40-year career in medical education by combining her love of health care with a passion for knowledge. After teaching immunology and clinical chemistry at a hospital in Minneapolis MN she enrolled at NCNM. Dr. Bettenburg graduated from the naturopathic medicine program in 1989 and completed a residency in family practice. In 1990 she began her private practice while also rekindling her dedication to education as she accepted a teaching position at NCNM. In 2004 Dr. Bettenburg was appointed dean of the School of Naturopathic Medicine where she was instrumental in establishing NCNM s national reputation for academic and clinical excellence until her retirement from NCNM in 2011. Her influence in advancing the naturopathic profession went well beyond NCNM and Portland. With a zeal for legislative advocacy on behalf of the naturopathic profession Dr. Bettenburg was well suited to serve as president of the board of directors for the Oregon Association of Naturopathic Physicians an organization she served in various capacities for almost 25 years. Nationally she was a board member of the American Association of Naturopathic Physicians and served as Speaker of the House of Delegates for the organization. Dr. Bettenburg served for 12 years on the Council on Naturopathic Medical Education (CNME) in a number of capacities including president from 2009-2013. The CNME is recognized by the U.S. Department of Education as the national accrediting agency for the naturopathic medicine profession. NCNM s president David J. Schleich PhD expressed his gratitude to Dr. Bettenburg for her decades of service to the profession of naturopathic medicine and for her contributions to NCNM. As dean of our naturopathic program Dr. Bettenburg set high standards at NCNM for years--for both our faculty and students. Her vast programmatic knowledge while serving as president of CNME continues to benefit all North American medical colleges seeking naturopathic accreditation or seeking to maintain accreditation. Correction On page 10 of the Practitioner Corner column ( Fit Over 40 ) in the November 2014 issue of Natural Practitioner the final sentence under the sub-heading Medicinal Supplements (bullet-point Curcumin) should have read These include a unique water dispersible form of curcumin know as Theracurmin a proprietary curcumin-phosphatidylcholine phytosome complex sold under the brand name Meriva a combination of finely milled curcumin and turmeric oil called BCM-95 sold under the brand name Curamin and a blend of curcumin and bioperine dubbed Curcumin C3 Complex. 16 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Go to naturalpractitionermag.com fairhaven for info about this advertiser By Daniel Breeman Natural Practitioner (NP) convened a panel of experts to discuss this movement toward a more shared practice and asked them their thoughts on what 2015 might hold as the CAM model continues to move in that direction. toward combining them with more mainstream medical therapies. NP What are some of the biggest challenges facing CAM practitioners in 2015 Did the industry meet or exceed the biggest challenges of this part year Gonzalez In the dietary supplement industry continuing to provide products with innovative ingredients that have clinical research to support them is especially important to the modern consumer. Consumers have a wide-range of options to choose from with retail professionalonly and online brands all vying for space in the marketplace and they are savvy about the quality and effectiveness of their supplements. Products backed by solid research with quality ingredients are key. Hanson One of the biggest challenges the industry has faced this year and continues to face currently is the rising cost of education. Naturopathic medical students pay the same exorbitant costs for education as conventional medical students and yet make significantly less money than their conventional counterparts have access to very few salaried positions and have next to zero opportunities toward public service loan forgiveness. If we want to continue drawing Participants include Emily M. Gonzalez ND Senior Scientific Development Associate Life Extension Gillian Hanson ND Holly Lucille ND RN The Body Well Shidfar Rouhani ND DC BSE-MS NR-EMT Core Faculty Bastyr University California and Clinical Faculty Member Bastyr University Clinic Amber Lynn Vitse BA LMT CN Northeast Educator for Garden of Life Emily M. Gonzalez Gillian Hanson Holly Lucille Shidfar Rouhani Amber Lynn Vitse A s we usher in 2015 and the cost of health care continues to rise rapidly in the U.S. the health care model is beginning to feel a seismic shift as complementary and alternative medicine begins to take its place among more traditional Western medicine models. The key word moving forward appears to be collaboration among health care practitioners who now seem more eager than ever to share their knowledge and break down the barriers that have separated the two sides for far too long. In fact recent numbers have shown that nearly 40 percent of adults report using complementary and alternative medicine prompting many physicians to embrace CAM therapies and move 18 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 bright dedicated people to our profession we need to create more opportunities for our graduates to thrive. We are making terrific strides in establishing an increasing number of residency positions for our grads but we have a long way to go. Lucille I think one of the main issues that continues to be a challenge is our identity. Too many people still think it is out of pocket and that they are tied to their insurance based doctors and don t understand that it is about partnership wellness and the approach not the agent. It is not just about Prozac vs. St. John s wort... it is so much more. There is also the problem of marketing and the outrageous claims from subpar manufacturing companies that simply wait for Dr. Oz to say something and then make it and sell it with no intention or integrity. Rouhani I see the CAM world plagued with a lack of collaboration. I spend a great deal of time explaining naturopathic medicine to fellow herbalists chiropractors and other healing art practitioners halfway through our conversation I get an almost universal response of we should collaborate on this or that. In the conventional medical world the area of expertise for a medical specialist is clearly defined and MDs are trained to refer and collaborate with other specialist. For example if your primary care doctor is having trouble determining the cause of your abdominal pain then you are likely to get a referral to a gastroenterologist (GI) with the specialty training to help you. In contrast a homeopath or herbalist may never consider that your case is complicated by underlying musculoskeletal issue that would improve with chiropractic care or physical therapy. I think the CAM world is still a few years out from meeting this collaboration challenge but I m glad to see that we are headed in that direction. Vitse I imagine my perspective may be a bit different from some practitioners though I m sure we can all agree that educating our clients patients is a big necessity. I really believe we are still in a place where we have to further create our market through education. I m still amazed at the number of well-educated people I come across who know very little about real health. We still have a lot of work to do maybe in a savvier way to educate the mainstream. NP Is the blend of traditional Western medicine with alternative medicine becoming more commonplace Is this a trend you expect to continue Gonzalez More and more doctors are using an integrative medicine approach in their practices. There are a multitude of integrative medicine training programs across the country and the world. Doctors everywhere are breaking free of the conventional one-size-fits-all approach to disease management. In the dietary supplement world novel formulas with scientific research are now available from forward thinking organizations. These products provide meaningful benefits for integrative practitioners and their patients. Hanson Yes I certainly see the integrative concept becoming more widely accepted. I find this to be especially true around diet exercise acupuncture and specific forms of bodywork like massage. I see more conventionally-trained doctors becoming increasingly disenfranchised with the medicine they can provide on a seven-minute appointment schedule. That coupled with the fact that their reimbursement is moving toward an outcome-based model seems to make them more open to alternative therapies that will safely produce positive results. This provides an enormous benefit for the patient. As CAM becomes more commonplace this also leads to greater communication between providers and more options for the patient. Lucille I would say it is more conventional Western medicine. But yes I think I see more of a blend for sure ...the benefits are that there is truly value in both systems but it is about empowering the user to understand the difference. Rouhani I have noticed an amazing shift over the last decade toward an increase in the blending of Western and alternative medicine. Increasingly you find that medical centers and large groups of medical practitioners have CAM practitioners on staff to provide their patients with a holistic approach to their healthcare. One really great example of this is the holistic model at the Cancer Treatment Centers of America where a cancer patient is cared for by a team of people that would include an oncologist a naturopathic doctor a nutritionist and many other CAM specialists. Vitse It depends on where you live. I just moved to Brooklyn. Finding integrative practitioners especially trying to match up insurance plans and locale is challenging. Again I think in part it s because we just aren t as savvy about our marketing. We aren t as visible because that is not our department. We just want to help people. Most patients and clients tie together several different practitioners in different areas. I d love to see more combined practices that are truly affordable. NP As health care costs continue to rise do you expect the role of CAM practitioners to gain greater acceptance Gonzalez Complementary and alternative medicine is based on prevention of disease through lifestyle and dietary means along with proper use of nutritional supplements. These kinds of interventions are inexpensive compared to most prescription drugs surgery and hospitalization. With the realization that many of the most common diseases we battle today (heart disease cancer depression) are lifestyle diseases a medical paradigm that helps prevent these diseases is what is needed. Hanson Health care costs continue to rise and perhaps more importantly insurance plans seem to have higher and higher deductibles even employer-sponsored plans. As patients bear more of the cost of their own care they inevitably become more price-sensitive. Because many CAM providers are not contracted with insurance providers their prices are generally far lower than the astoundingly markedup costs we see from traditional providers who are contracted with insurers. As a result I think CAM providers that provide primary care services will see more patients willing to pay reasonable out-ofpocket rates. So I think there will be more acceptance toward seeing CAM providers in that respect. Also the momentum continues for a greater push toward the prevention model of disease of which diet lifestyle and stress reduction plays a huge part. We need to be more vocal and specific about what CAM has to offer in this regard and continue providing high-quality studies to back up our claims. Lucille Yes and no. People might cling to what they can get from their insurance JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 19 or if we do a good job we can help them actually take better care of themselves and their families. Rouhani Complementary and alternative medicines are amazingly effective and by their very nature of efficacy are gaining widespread acceptance despite rising health care costs. I will never forgot what a patient of mine once said as he was about to leave my medical center in Portland OR Doc it is cheaper for me to pay you out-of-pocket for the visit or two I need each month than for me to try to pay for insurance. The work I do as a naturopathic doctor gets people feeling better faster so they don t have to be seen so many times for so many years. Vitse Well I don t know about anyone else but I was disappointed to find I could not actually choose to pay a small amount for mere catastrophic-level health care and save my money to spend the way I wished. On the other hand if there are tests medications and therapies that are not covered or too expensive for patients I do think they will seek alternatives. Like in Europe it can be prohibitive to get into your MD so many people find alternatives The People s Medicine. NP Does the CAM model need to change moving forward In what ways specifically Gonzalez Instead of thinking of this form of medicine as complementary and alternative the paradigm needs to change so that this form of preventive medicine is thought of as the foundation for health and wellness. This can save both money and lives. Hanson This is a small part of the CAM model but I m concerned about how often our profession is associated with an ascetic style of living particularly around diet. It scares people off and it lends itself to a considerable amount of shaming and guilt that truly serves no one. Specifically I think we need to shift our dialogue away from messages like gluten free diary free etc. and more toward an emphasis on flexibility and abundance with messages like veggie full. I feel very strongly about getting away from a good bad paradigm of food choices. Lucille We need to be more patientspecific more approachable and patientoriented and less profit-oriented for things other than our time knowledge and service. NP Are you seeing any major shifts ahead in the CAM industry Hanson I believe technology will play a greater role in how CAM providers engage with their patients specifically through the use of wearables apps and other monitoring devices. Making diet and lifestyle changes is very very hard. These technologies provide tools to engage the patient in their health during all those moments when they are not sitting right there in your office i.e. at those times when it s much more challenging to focus on healthy choices. It s the ultimate way to meet people where they are at. They help provide objective metrics to track progress. Lastly change can be painful and apps and wearables can make the process truly fun. Having fun leads to engaged healthier patients invested in their wellbeing. Lucille I hope so but I m not sure. We need to continue to educate the consumer Rouhani I think growth hormone (GH) will be a hot trend in 2015. I ve seen exponential interest in it s many uses over the last decade for everything from antiaging to getting tissues to heal years after injury. I know it is a little taboo given the overuse in sports but in lower clinical doses I have used it to do amazing things. NP Will the role of natural practitioners changes in the year ahead What can they do to continue to ensure the best care for their patients Gonzalez As the Affordable Care Act is enacted and natural practitioners see how this legislation is regulated in their state it may shape how they can provide care. Natural practitioners from accredited schools have extensive training that allows them to provide effective primary care. Now through certain language in the Affordable Care Act (Section 2706 - the non-discrimination provision of the Affordable Care Act) there may be greater insurance coverage that will help patients find an integrative practitioner and help the country fill the primary care gap. To ensure the best care for their patients integrative practitioners should use science-based dietary supplements that provide proven benefits. Hanson My hope is that the role of the natural practitioner continues to shift from a solo voice on the periphery to a trusted valued voice as part of the patient s health care team. The best thing we can do for patients is to be in communication with the rest of the team. Now I m biased--I m part of the founding team of a San Francisco-based start-up PicnicHealth that helps patients collect and electronically organize their medical records and keep all providers up-to-date on what the others are doing. I strongly believe that truly holistic medicine means that all providers are on the same page and this is the best thing we can do to ensure the best care for our patients. Lucille Try to get them (patients) not to need us (practitioners). Rouhani Patients continue to expect more and more from natural practitioners. One area where I see an expansion of my role is providing customized medicines. I have never been one for stocking my office shelves with lots of products. Rather I see that I can ensure the best care for my patients by making them a customized medicine. For my practice this includes the gambit from custom encapsulations to botanical tinctures to customized creams and salves. No two patients of mine have the exact same need so no two of my customized preparations are the same. In my opinion this is the best method for treating every patient for his or her unique case. Vitse We must expand and deepen our offerings expand our referral lists work together in more collaborative networks and keep up to date on the latest information and research. So many truths we have told for so long to our clients and patients truths that were demonized by the conventional establishment have been proven in the last few years. (Importance of D3 importance of K2 microbes and gut health leaky gut and autoimmune diseases as well as cognitive function fluoride in water etc.) If we keep up and remain diligent we will continue to reveal profound and important information and gain stronger footing among all practitioners. 20 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Keeping Hearts Beating Strong Integrative practitioners can help turn tables on cardiovascular disease. By Cristina Goodwin F ebruary is the one month out of the year devoted to healthy beating hearts and to raising awareness of heart health. Studies suggest that integrative medicine can play a key role in the battle against cardiovascular disease (CVD) which has long been and still is America s deadliest disease. According to the American Heart Association (AHA) data from 190 countries includes scientific evidence that heart disease is the cause of 17.3 million deaths per a year. Further the AHA believes that by the time 2030 comes around the number of deaths from CVD is expected to increase to more than 23.6 million and in America alone one in four (600 000) people continue to die from heart attack or stroke annually. The Centers for Disease Control & Prevention (CDC) explained that being diagnosed with CVD is not only life threatening but also extremely costly. The amount of money spent on health care services medications and lost productivity for patients with CVD averages out to be 108.9 billion dollars in the U.S. alone even though the CDC shows that approximately 47 percent of all cardiovascularrelated deaths occur suddenly and most often outside of a hospital. Lin Weeks Wilder MD and renowned author warns that the increase in CVD could lead to a death sentence due to surgical coronary arterial bypass angioplasty and use of thrombolysis or clot busting agents that can actually cause more harm than good through reverse side effects. She references to the Framingham Heart Study the longest running population study made of individuals at risk for heart disease which has statistically provided more than 50 years of data that is considered reliable enough to create an absolute risk score. She does believe however that the risk can be prevented if practitioners look at the causes and therefore so can the number of lives JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 21 Keeping Beating Hearts Strong taken by CVD. Causes of CVD Dr. Wilder said that three factors come into play for the increased mortality rate due to CVD. First there is an increase in the elderly population. Secondly Type 2 diabetes has been prevalently rising in American adults and children and finally there has been a corollary and casual epidemic of obese Americans regardless of age. We have made great progress in reducing deaths yet we re also seeing a rise in diabetes among children and childhood obesity rates remain stagnant. We must find ways to correct these troubling trends or we risk losing ground added Elliot Antman MD president of AHA professor of medicine and associate dean at Harvard Medical School and senior physician in the cardiovascular division of Brigham and Women s hospital in Boston. Additionally the AHA has found other underlying causes of heart disease in the U.S. These include smoking lack of physical activity cholesterol diet blood pressure weight and blood sugar. Mayline Paez RN for Florida-based Life Extension insisted that practitioners need to focus on other factors (besides cholesterol) that contribute to cardiovascular disease such as elevated levels of homocysteine C-reactive protein and low vitamin D levels as well as excess blood sugar levels elevated levels of inflammation and oxidized LDL. And adding to what Dr. Paez said Dr. Rodger Kendall with Vermont-based DaVinci Laboratories believes that reducing inflammation may in fact be more beneficial than high cholesterol when predicting a heart attack or stroke. Silent inflammation (chronic low-grade inflammation) plays a big role in most chronic illnesses and especially with cardiovascular disease from irritation of artery damage high blood pressure and in the blockage of arteries from clots or plaque formation he explained. indicating that there are a variety of warning signs young adults should be aware of in order to flag the condition early before it worsens. The CDC s list of CVD symptoms include chest pain or discomfort super body pain or discomfort in the arms back neck jaw or upper stomach shortness of breath nausea lightheadedness and cold sweats. Offering Solutions Dr. Wilder offered 10 tips on how to manage cardiac health however what was not already mentioned in this article include sleep seven to eight hours a day cut down on sugar cut down on carbs become your own expert on heart health and heart disease develop a consistent prayer or medication and of course decide to partner with a doctor. In relation to cardiovascular health and natural remedies Life Extension is interested on how antioxidants play a role in preventing heart disease. Lycopene is a great example said Dr. Paez. In one study patients with existing heart disease experience a 53 percent widening of blood vessels in response to lycopene supplementation. The company also noted that vitamin K plays a large role in preventing heart disease and that higher levels are associated with a lower risk of cardiovascular mortality. Life Extension carries a handful of products for practitioners to recommend to their patients. The first one they offer is their Endothelial Defense with FullSpectrum Pomegranate which ultimately reverses atherosclerosis. Dr. Paez refers to an Israeli study where within one whole year of taking a pomegranate juice supplementation researches found that the fruit had lowered carotid intima thickness lowered systolic blood pressure improved blood flow and reduced oxidized LDL. The company s Super Omega-3 EPA DHA with Sesame Lignanas & Olive Fruit Extract is another option. This supplement offers a good source of omega-3s found in fish oil. Next their Super K with Advanced K2 Complex provides the body with a healthy amount of vitamin K to inhibit arterial calcification by keeping calcium out of arterial walls Dr. Paez explained. Lastly Super Ubiquinol CoQ10 with Enhanced Mitochondrial Support is a great source of CoQ10 which increases ATP or the fuel the heart needs in order One Step at a Time Adding a supplement regiment to a routine healthy diet and moderate exercise is priority explained Dr. Kendall. But determining which supplement is most appropriate is not always easy. Before patients can start a supplement plan the discussion with patients needs to take place. It s easy to start a conversation with patients about cardiovascular health because they re likely expecting a mention in each appointment. Even if that s just because the practioner is wearing a stethoscope Dr. Kendall said. Doctors should begin the conversation with their patients with referencing to their diet and exercise later they can recommend an alternative and integrative solution. Natural practitioners are often well versed in discussing lifestyle changes but sometimes keeping up with the latest research into cardiovascular health news can be difficult he explained. In addition to short-term prevention for Baby Boomers practitioners need to be aware that there s a demand for longterm prevention solutions as well. Dr. Paez said there is new evidence that heart disease can begin in people in their 20 s therefore practitioners need options for a heart healthy lifestyle decades before the disease becomes toxic. Researchers point to scientific evidence Three Myths About Heart Disease r. Lin Weeks Wilder addresses her top-three myths about heart disease and what may or may not lessen one s risk 1) Cholesterol lowering drugs known as statins decrease the risk of heart disease. The risk and benefit data varies considerably among experts also our bodies need fats not including transfatty acids to function. 2) Diabetes won t threaten your heart as long as you are on medication however it is a number one risk factor in the Western world. In addition diabetes can be avoided through diet and exercise. 3) You should avoid exercise after a heart attack. This is false since exercise is extremely important when recovering from a heart attack. D 22 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 to run efficiently. According to Dr. Paez studies have shown that CoQ10 improves the survival rate of heart failure patients. It also decreases oxidized LDL restores endothelial function and lowers high blood sugar levels. Dr. Kendall explained that DaVinci offers a variety of cardiovascular support formulas as well as products that specifically target the circulatory system the mitochondria and other areas of health such as inflammation that can affect the heart. The company has two conditionspecific products for consumers to take. First is Ubiquinol the most potent form of CoQ10. It is absorbed three to four times more efficiently than the fat-soluble ubiquinone form of CoQ10 which makes it easier to access the cells. However the company s most popular and most marketed cardiovascular health ingredients are vitamins A D and K. Dr. Kendall insists that the combination of all three vitamins supports proper cardiovascular function as well as the body s natural way to produce cytokine. The K2 in the formulas is in the MK-7 (menaquinone) form and works primarily outside the liver in the bone and blood vessels he said. Vitamin K2 helps to maintain the elasticity of the arteries helping support cardiovascular function the company said. When vitamins A D and K2 are combined it is believed that they play a critical role in preventing the build-up of calcium in the arteries. Therefore the balance of having all three vitamins together is the key to success of a supplement formula explained Dr. Kendall. Red Yeast Rice (Monascus purpureus) by Pennsylvania-based Sylvan Bio Inc. is a natural alternative to support healthy LDL cholesterol levels stated Orrie Rondinella director of sales and marketing for the company. To confirm the effectiveness of red yeast rice the company offers scientific evidence that red yeast rice is safe and effective. While not a study per se the 2013 journal of Missouri Medicine published a red rice yeast overview and included results from five different studies he explained. The outcome was that 1 200 mg to 4 800 mg of red yeast rice that was taken in individual doses was positively effective in maintain- ing health LDL cholesterol levels. Sylvan Bio Inc. noted that practitioners should use red yeast rice that s only organic made under strict quality standards and sourced 100 percent in the U.S. Women ages 40 and up tend to be the primary purchasers Rondinella said regarding the company s cardio-targeted supplement although men buy the product as well. However red yeast rice works equally as well in both men and women who are looking for integrative and alternative solutions to promote heart health. The company offers consumers two red yeast rice products. First is their well-known and staple product Sylvan Synastat Organic Red Yeast Rice (Monascus purpureus) that helps to maintain healthy LDL cholesterol levels. Their rice is USDA (U.S. Department of Agriculture)-certified organic and is processed under strict quality control in the U.S. said Rondinella. It is available in a 120-ct. bottle and a 240-ct. bottle and also comes in smaller vegetarian capsules as well. The second red yeast rice product is Sylvan Synastat Red Yeast Rice with CoQ10 which had recently launched this January. What distinguishes this product is that it is currently the only 100 percent U.S. sourced red yeast rice on the market with CoQ10 available the company stated. Rondinella mentioned one 2009 double-blinded placebo study published in the journal Annals of Internal Medicine where researchers examined the effects of red yeast rice for dyslipidemia in 62 patients. Half of the participants were randomly assigned 1 800 mg of red yeast rice and the other half was given a placebo. The conclusion provided evidence proving that the red yeast rice group had decreased their LDL cholesterol levels minus increased CPK or pain levels. Additionally the study suggested that the combination of red yeast rice and a few lifestyle changes might be the right way to go for patients suffering from dyslipidemia. cent by the year 2020. Globally the AHA is working with the United Nations (UN) and various international cardiology groups to adapt its evidence-based programs to be made available in surrounding countries. Their report estimated that 11.4 million deaths of people between the ages of 3069 and 15.9 million deaths among people 70 and older could be delayed or even prevented in the year 2025. That is if the worldwide target audience is willing to reduce their use of tobacco and alcohol decrease their salt intake maintain a healthy weight and lower blood pressure and glucose levels. In 2011 the journal Circulation published a double-blinded placebo controlled study that found that CVD and the amount of money spent to treat the disease would increase substantially in years to come. Yet in order to provide solutions the report concludes In the public arena more evidence-based effective policy combined with systems and environmental approaches should be applied in the prevention early detection and management of CVD risk factors. Through a combination of improved prevention of factors and treatment of established risk factors the dire projection of the health and economic impact of CVD can be diminished. One in four (600 000) Americans die from cardiovascular disease (CVD) including heart attack or stroke annually. 47 percent of all cardiovascular-related deaths occur suddenly and most of the time outside of a hospital. 11.4 million deaths of people between the ages of 30-69 and 15.9 million deaths among people 70 or older could be delayed or even prevented in the year 2025. 108.9 billion dollars is spent in the U.s. on services medication and lost productivity. Healthy Take Aways Looking Ahead According to the AHA the U.S. is working to improve cardiovascular health in Americans by 20 percent and reduce the number of deaths related to CVD including heart attacks and strokes by 20 per- FOR MORE INFORMATION Life Extension (800) 544-4440 www.lef.com Sylvan Bio Inc. (866) 352-7520 www.sylvaninc.com DaVinci Laboratories (800) 325-1776 www.davincilabs.com JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 23 Developing Adherence Patient Practitioners can lead their patients to the water of therapeutic compliance and make them drink. By Janet Poveromo A lthough the words compliance and concordance are sometimes useful in the medical field the term adherence is being increasingly used. It comes from the Latin word adhaerere which means to cling to keep close or remain constant. According to Merriam Webster s Dictionary it is defined as the act of adhering steady or faithful attachment a definition that appropriately conjures up the tenacity that patients need to achieve in sticking to a therapeutic regimen. I feel there is a huge difference between compliance and adherence said Holly Lucille ND. Compliance is doing what someone says to do adherence is the faithful attachment to something and no it isn t easier ... it is much harder unless the practitioner works really hard to get the adherence part of things. When you dwell in conventional reductionist medicine with a here take this approach ... that is easy but dietary recommendations dose dependent supplement regimens--lifestyle interventions--that is tough Deborah Waddell Dipl Ac LAc agreed I believe compliance is a bit harder using natural remedies because they most often require being taken two to three times a day and of course usually take longer to see results than taking Western drugs she said. Patient s need to be educated on whatever remedy they are taking and I also always encourage emailing or calling the office with questions. I have found that the most compliant of all my patients were those I was treating for fertility. They have such a strong need (I believe a genetic need to bear children) that they will do whatever they are told to increase their chances of conception. Many patients that don t comply are used to getting immediate results with Western drugs even though they are only masking the symptoms not treating the root cause Waddell added. I always explain that it will take time before they see lasting results. Dr. Lucille said assessment of patient compliance should take place on the first follow-up visit. The initial visit is best laid plans and then assessment of that is the key Waddell noted that as an acupuncturist she often prescribes dietary recommendations as well as Chinese herbal formulas. If there is no improvement in their condition I often asked if they are compliant with their diets and or formula s that I have prescribed. If they say no I try to ascertain how I can make changes that will make compliance easier. I have found non-compliance happens most often with the dietary changes I suggest. Also due to a high level of compliance with powdered herbal formulas or those that require cooking I have resorted to using patent 24 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 herbal formulas in pill or tablet form. Responding to Patient Non-compliance Practitioners should consider a straightforward response to patient non-compliance. I respond by telling them they will not get well if they refuse to be compliant yet being patient with them and seeing if we can find a better way together to make compliance easier said Waddell. Of course if the patient refuses compliance then I recommend that maybe it is not the right fit and they may want to try some other form of treatment. Dr. Lucille said its about understanding the disconnect. When I first began practicing over a decade ago my boundaries with my patients were flimsy at best she recalled. I was so motivated and passionate about them doing well and following through with my recommendations that I would end up walking them to their cars while still educating still explaining well after our visit had ended she said. I think if I could have gone home with a few of them to help with implementation of the plan I would have. Of course upon the return visit if I learned that the plan wasn t followed or that my patient hadn t progressed I took it personally and wondered what I could have done better. Thankfully with time and practice my boundaries firmed up and I began to trust deeply in my work. It was helpful to remind myself that I truly am only part of the equation in this partnership and cannot be successful without my patients doing their part as well. However I was still craving some reassurance that after the visit was over and they had left the supportive almost cheerleading environment of my office that my patients could comply with my recommendations. One of the tools Dr. Lucille incorporated to assist in assessing this issue is called the Adherence Loop. MedCenter Systems help users avoid confusion about proper dosage and timing. Tools of Adherence In an age of increased patient engagement making sure patients know why they need a medication is more important than ever said Rajiv Shah MD CEO of MyMeds a company that provides online and mobile medication management tools. For so long it s been a doctor knows best society said Dr. Shah a nephrologist in Edina MN. But it s evolved so patients are now our partners. They re not going to [take the pill] unless they understand why it s important. The means of communicating with patients and caregivers about medications also needs to be considered Dr. Shah added. For example he noted older people want print publications while their oftenyounger caregivers prefer mobile because it s more convenient. So you want a full platform that s print web and mobile. The timing of communication is another factor to be looked at and medications are often discussed shortly before a patient is discharged from the hospital. The last thing a patient who wants to get the hell out of the hospital is going to do is sit there and listen for 20 minutes to somebody go over all this stuff with them he noted. When you get home to your safe environment that s when you re much more receptive to information. To figure out which patients need to be targeted with more intense interventions to improve their adherence MyMeds tracks claim data to find out whether patients are refilling their prescriptions and also looks at self-reported tracking data. The company then tells the care team Here are the people who are less than 80 percent adherent that they can target interventions to Dr. Shah explained. Easier Dosing For people who are tired of forgetting when to take their medication or vitamin supplements a MedCenter Systems device may be the solution. MedCenter Systems helps users avoid confusion about proper dosage and timing. This system emphasizes the Date rather than the Day of the Week. This repetition of the Date helps ensure consistency even if the user is unsure whether it is Monday or Tuesday. Millions of Americans do not take their medicines correctly. People simply forget to take them are confused about when and in what amount to take them or lack the personal organization to carry out the daily task. Growing up my father would forget to take his necessary medication which would result in him fainting and passing out said Martin Cooper the inventor of The MedCenter System. Coming up with a way to organize my parents medications and encourage their adherence was the true motivation behind creating the system he added. The MedCenter System has a suggested retail price of 69.95 with the talking LCD clock and 34.95 without it. Other products include the Monthly Mini Monthly Organizer ( 24.95) Traveler Weekly Organizer ( 19.95) Daily Pill Organizer ( 18.95) Daily Pill Organizer with Alarm ( 28.95) and 5-Alarm Sport Watch ( 24.95). Taking medications on a set schedule is crucial for managing health. With the MedCenter System taking medications on schedule becomes a part of the patient s daily routine. The Adherence Loop Model Patient adherence can be defined as a patient playing an active and willing role in their plan of care to gain maximum benefit. In order for people to adhere to a plan there are certain action points that they need to move through almost in a loop type fashion as described in The Adherence Loop. developed by Dr. Devorah Klein. JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 25 Developing Adherence Emerson Ecologics Launches Practitioner Resource Center Emerson Ecologics (Manchester NH) recently unveiled its newly designed Practitioner Resource Center a full suite of clinical and business tools resources and education designed to help integrative health care providers find success as healers and business owners. The Practitioner Resource Center includes a rich variety of materials that can help health care providers stay up to date on clinical knowledge and treatment plans improve patient compliance and learn new strategies for growing their practice and more. We ve always been committed to helping our customers succeed as integrative health care practitioners and our newly designed Practitioner Resource Center is an extension of that commitment said Dr. Jaclyn Chasse medical director for Emerson Ecologics. We recognize how busy our customers are so our educational resources and materials are available in many different formats. And the majority of what we offer is available free of charge. The Practitioner Resource Center offers clinical references FAQs peer-to-peer support via email or phone educational webinars detailed product literature the IGNITE series of business-oriented workshops and more. Sample resources include Dietary and lifestyle recommendations for specific health conditions Online databases listing drug depletions and interactions Personalized answers to questions about integrative health treatments from Emerson s Medical Education team Summaries of selected clinical research on select dietary supplement ingredients Educational materials and webinars designed to help practitioners grow their business and attract new patients Active compounds suggested dosage and potential interactions for botanical herbs Calendar links and resources designed to help practitioners stay on top of industry research and or maintain professional credentials Suggested dosage and potential interactions for vitamins and supplements Patient Believe People need to believe that they have the condition that the recommendations will work and that they can be successful. Frame They need to build a mental model or framework of how the recommendations will work on their condition. Know They need to know the rules and what to expect. Prompt Knowing what to do is often not enough. People need cues and reminders to prompt action. Act Action requires resources physical cognitive emotional social and financial. Reinforce Feedback reinforces belief to strengthen and drive adherence. When the Adherence Loop is Broken If upon the follow up visit the practitioner notices that this loop has been broken somewhere and compliance has become an issue there are diagnostic questions to ask to help figure out where Belief Do patients want to change or is someone else telling them they need to change Do patients believe there is really a solution that will work for them Do patients believe they can have success Frame Do patients have an accurate understanding of their health Do patients have an accurate understanding of how the recommendation works Do they know what to expect from carrying out the recommendations Where are the misunderstandings (past experience stories fear hope) Know Do patients understand the rules of the regimen Are patents overwhelmed by information Are patients not getting information Are patients getting misinformation Prompt Are patients forgetting to take doses Is the regimen hard to keep track of (inconsistent not memorable alien to the patient s other routines) Act Is the therapy physically hard to take (painful difficult to administer time consuming) Is the therapy socially challenging (embarrassing awkward requires space or equipment) Is it difficult to get (financially logisti- cally) Does it require the help of another (caregiver) Reinforce Is there feedback that the therapy is working Are there any negative side effects Do patients notice an immediate or delayed improvement Are people rewarded for action Did the action meet expectations I have had countless experiences where a plan was able to be exponentially more effective once I found out through this tool where either the potential or real disconnect was Dr. Lucille said. Consider a collaborative effort. Waddell said she always tells her patients that they become a team hence we need to work together to find what will help them best with compliance she said. When it comes to diet I will often provide the patient with easy low fat whole foods plant based recipes and even a grocery shopping this. I also recommend websites that will keep them motivated and also provide them with valuable information. Do they give up on patients No said Waddell but a doctor has to understand that it takes time to spend with the patient to help them be compliant. Many patients want to be compliant but just don t know where to begin. Dr. Lucille also doesn t give up. Keep searching for obstacles to cure. Adherence to dietary recommendations dose dependent supplement regimens and other lifestyle interventions can be more difficult relying solely on pharmaceutical drugs. Consider a straightforward response to patient non-compliance. Dr. Devorah Klein developed The Adherence Loop to help practitioners determine where a patient has broken adherence. Developing a sense of teamwork with a patient may improve adherence. Healthy Take Aways FOR MORE INFORMATION Emerson Ecologics (800) 654-4432 www.emersonecologics.com MedCenter System (866) 600-3244 www.medcentersystem.com MyMeds www.my-meds.com 26 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 PRODUCT FOCUS Searching for Joint Relief By Shar i Bar banel he adult human body is composed of 206 bones and the joints occur where two bones meet. Further joints make the body flexible and without them movement would be practically impossible. But as time goes on the body can put a lot of stress on the joints causing wear and tear. While staying at a healthy weight and being active is ideal the sad truth is that many Americans are overweight because they do not get enough exercise and eat diets that are high in carbohydrates and processed foods and low in vitamins and nutrients that the body needs. According to the Centers for Disease Control and Prevention (CDC) over the past 20 years there has been a dramatic increase in obesity in the United States and rates remain high. More than one-third of U.S. adults (34.9 percent) and approximately 17 percent (12.7 million) of children and adolescents aged 2-19 years have obesity. Obesity affects the body in a number of ways. It affects the joints in particular by putting extra strain on the body which can result in joint pain inflammation and T arthritis. According to the CDC people who are overweight or obese report doctordiagnosed arthritis more often than people with a lower body mass index (BMI). The CDC also reported that 66 percent of adults with doctor-diagnosed arthritis are overweight or obese compared to 15.9 percent of adults who are under normal weight. Further the CDC noted that weight loss of just 11 pounds can reduce the risk of developing knee osteoarthritis among women by 50 percent. But obesity is not the only cause of arthritis as age family history previous joint history are also factors. According to the CDC it is estimated that 60 million people will have some form of arthritis by the year 2020. Osteoarthritis is the most common form of arthritis and approximately 26.9 million American adults are affected. Osteoarthritis occurs when the wear and tear of the joints cause the bones to touch and grind against each other causing pain and restricted movement. Rheumatoid arthritis the other main type of arthritis which affects approximately 1.3 million Americans is two to three time more likely to affect women than men. Rheumatoid arthritis occurs when the body s immune system attacks the joints causing inflammation especially in the wrists fingers feet and ankles. Eating an anti-inflammatory diet and getting the proper amount of exercise are imperative for healthy joints. The government recommends that adults take part in aerobic activity of moderate intensity for at least 150 minutes per week (or vigorous intensity for 75 minutes per week) while it is recommended that children get at least 60 minutes of physical activity daily. Low impact activities such as swimming cycling and water aerobics are recommended because they do not put as much stress on the joints. In addition to a proper diet and exercise dietary supplements and topical treatments may also provide relief to the joints. Below is a sampling of joint health products available for natural practitioners to offer their patients. ArthoMed EuroMedica s ArthoMed (suggested price 46.95 60 capsules) supports joint and spine health flexibility and comfort and contains clinically studied BCM-95 Curcumin and BosPure Boswellia. Additionally ArthoMed is a proprietary formula that effectively promotes joint health and cartilage formation. It safely modulates major signaling and biological pathways of the body that influence joint mobility and health. ArthoMed supports healthy cartilage structure optimizes comfort and mobility in articular joints and spine and enhances joint lubricant production. This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose treat cure or prevent any disease. Joint Flex A glucosamine and chondroitin sulfate combination formulated to encourage elasticity and movement in joints and connective tissue Joint Flex (suggested price 44.56 120 capsules) from Priority One Nutritional Supplements Inc. promotes the body s natural ability to heal damaged tissues enhancing the synthesis of glycoproteins while building healthy connective tissue. Chondroitin sulfate is part of a large protein molecule (proteoglycan) that gives cartilage elasticity. This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose treat cure or prevent any disease. For more information call (866) 842-7256 or visit www.euromedicausa.com. For more information call (800) 443-2036 or visit www.priorityonevitamins.com. RheumActive Patient One RheumActive nourishes joints and connective tissues with structural components needed for cartilage regeneration lubrication and repair. With inflammation-modulating compounds including Meriva Turmeric Phytosome and Celedrin cetylated fatty acids RheumActive promotes rapid relief of stiffness and aches while supporting long-term joint comfort flexibility and range of motion. ChondroActive supplies type II collagen chondroitin sulfate and hyaluronic acid building blocks of joints and connective tissue matrix. (NEM) Natural Eggshell Membrane supplies glycosaminoglycans plus other components of healthy joints connective tissue and synovium. RheumActive is formulated for peak bioavailability and digestive comfort. For more information call (877) 723-0777 or visit www.patientoneformulas.com. JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 27 PRODUCT FOCUS Function & Comfort Pure Encapsulations Joint Complex (single dose) supports joint function and comfort with cartilage building blocks and herbal extracts in convenient one-per-day dosing. Joint Complex offers UC-II undenatured typeII collagen complex. In a randomized doubleblind trial 40 mg of UC-II was more than twice as effective in promoting joint health as 1 500 mg of glucosamine and 1 200 mg of chondroitin as rated by WOMAC VAS and the Lequesne functional index. This formula also helps maintain connective tissue and joint lubrication with MSM and HyaMax a low molecular weight hyaluronic acid. Boswellia and enhanced absorption curcumin are included to target cytokine balance and joint comfort. The suggested price is 34.90 for 30 capsules and 84.70 for 60 capsules. This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose treat cure or prevent any disease. Soft Chews Each Joint Health Soft Chew (suggested price 31.99 30-ct.) from Redd Remedies contains the clinically proven therapeutic dose of 500 mg NEM (natural eggshell membrane). In three separate and published human clinical trials of osteoarthritis of the knee more than 50 percent of participants noticed improvement in joint pain and stiffness in as little as to 10 days. In addition eggshell membrane has been shown to significantly reduce pro-inflammatory cytokines. NEM naturally contains compounds essential to joint health such as collagen hyaluronic acid glucosamine chondroitin and sulfur-based amino acids. For more information call (888) 453-5058 or visit www.reddremedies.com. For more information call (800) 753-2277 or visit www.pureencapsulations.com. Joint Formula SierraSil Joint Formula 14 from SierraSil Health Inc. calms aches and stiffness from activity age and even some conditions in 14 days or less according to the company. The mechanism of action is complimentary to glucosamine as SierraSil (suggested price 34.95 90 capsules 59.95 180 capsules) supports a healthy inflammation response and has detoxifying properties and trace minerals. SierraSil from the U.S. Sierra Mountains has been rigorously studied for safety and efficacy in human trials in-vitro and invivo research. The peer-reviewed published studies have earned two U.S. patents. With a 10-year record of strong customer satisfaction contact us for more info. For more information call (877) 743-7720 or visit www.sierrasil.com. Xtra Support Pro Omega Joint Xtra (suggested price 51.95 90-ct bottle) from Nordic Naturals is the only product on the market that combines fish oil with clinically proven levels of Patented UCII Undenatured Type II collagen. This unique combination of concentrated fish oil UCII and glucosamine sulfate supports joint health and comfort in three ways 540 mg EPA 340 mg of DHA supports the production of beneficial series 3 prostaglandins 40 mg of UCII (10 mg of undenatured Type 2) is clinically shown to increase joint comfort and mobility and 1 500 mg of glucosamine sulfate serves as building blocks for collagen. For more information call (800) 662-2544 or visit www.nordicnaturals.com professionals.php. Arthro-Immune Life Extension s Arthro-Immune Joint Support (suggested price 28.80 60 vegetarian capsules) combines two clinically validated plant extracts into one powerful formula to help ease inflammation. Andrographis paniculata has received acclaim for its beneficial effect on inflammation. Arthro-Immune Joint Support contains PARACTIN Andrographis extract which has demonstrated its efficacy in easing inflammation in human clinical in-vivo and in-vitro studies. Curcumin is a compound that is universally recognized for its impressive antioxidant and fluid-regulating properties. ArthroImmune Joint Support also contains BCM-95 Bio-Curcumin which is considered the gold standard curcumin with bioavailability far superior to that of most curcumin extracts. For more information call (866) 585-1435 or visit www.lifeextension.com. Joint Wellness Santura Wellness Joint Health Support Formula from America s Finest Inc. contains Boswellin Curcumin C3 Complex and ginger root extract which are powerful antioxidant ingredients that support joint function and also relieve temporary joint inflammation and pain that may occur after overexertion during intensive physical activity. Santura Wellness Joint Health Support Formula also contains BioPerine which improves absorption of the nutrients. For more information call (800) 350-3305 or visit www.afisupplements.com. 28 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 NATURAL STANDARD MONOGRAPH Garlic Based on a systemic review of scientific literature edited and peerreviewed by contributors to the Natural Standard Research Collaboration. Scientific Evidence USES GRADE A B C C C C C C C C C C C C C C C C C C C C G arlic is an herb widely used for the treatment and prevention of heart disease and cancer. Research suggests that tablets with dehydrated garlic powder may modestly reduce total cholesterol for up to 12 weeks. Garlic s long-term effects on cholesterol and heart health remain unclear. Early evidence suggests that garlic may slightly reduce blood pressure and prevent blood clotting. Several studies report that regular consumption of garlic (particularly unprocessed garlic) may reduce the risk of several cancer types including stomach and colon. Multiple cases of bleeding have been associated with garlic use. Caution is warranted in people who are at risk of bleeding and before some surgical and dental procedures. Tradition Theory Abortion inducing age-related memory disorders aging skin allergies Alzheimer s disease anthrax antioxidant antispasmodic (suppressing spasms) antitoxin antiviral anxiety arrhythmia (abnormal heart rhythm) arsenic poisoning arthritis asbestos lung protection asthma bile flow stimulant bladder disorders blood clot prevention bloody urine bone and wound healing bronchitis chemotherapy toxicity cholera contraception cough cytomegalovirus (virus of the herpes family) dementia (prevention) diaphoretic (promote sweating) diarrhea (traveler s) digestive aid diphtheria (bacterial infection) diuretic (increasing urination) doxorubicin cardiotoxicity (protection against heart damage) drug toxin induced hepatotoxicity (acetaminophen) dysentery (bloody diarrhea) earache emetic (causing vomiting) energy expectorant (increasing mucus) fat burning fatigue fever flu gallstones gastrointestinal hypermotility (overactive intestinal tract) gentamicin toxicity glaucoma (increased eye pressure) hair growth headache heartburn hemorrhoids HIV AIDS hormonal effects immune system stimulation inflammation inflammatory bowel disease kidney disorders kidney toxicity leukemia libido lung disease lymphangitis (inflammation of lymph nodes) malaria menstrual flow stimulant methicillin-resistant Staphylococcus aureus methotrexate toxicity muscle spasms neuroprotection obesity osteoporosis painful menstruation peptic ulcer disease pneumonia premenstrual syndrome (PMS) psoriasis (skin disease) radioprotection Raynaud s disease (blood vessel disorder) ringworm sedative sexual arousal sinus congestion snake venom protection spermicide stomachache stress stroke toothache tuberculosis tumor (breast fibromatosis) typhus urinary tract infections vaginal trichomoniasis (sexually transmitted disease) vaginitis (vaginal inflammation) warts well-being whooping cough wound healing. Dosing Adults (18 years and older) For an antifungal 1 milligram per kilogram of body weight of a garlic extract (Allidridium) diluted into 500 milliliters of saline has been injected in the blood over four hours daily for less than one month. For athletic injuries 80 milligrams of allicin (garlic component) has been taken by mouth for 14 days. For athletic performance a single dose of High blood pressure High cholesterol Heart disease (risk) Antibacterial Anti-fungal Atherosclerosis ( hardening of the arteries) Athletic injuries Athletic performance Benign breast diseases Cancer Chest pain (angina) Chronic venous ulcers (ulcers from poor circulation) Circulation Common cold upper respitory tract infection Cystic fibrosis Dental conditions Familial hypercholesterolemia (inherited high cholesterol) Gastic cancer prevention Gastritis (inflammation of stomach) Hair loss Heart disease prevention (secondary) Heavy metal lead toxicity A STRONG SCIENTIFIC EVIDENCE B GOOD SCIENTIFIC EVIDENCE C UNCLEAR OR CONFLICTING SCIENTIFIC EVIDENCE D FAIR NEGATIVE SCIENTIFIC EVIDENCE F STRONG NEGATIVE SCIENTIFIC EVIDENCE NATURAL PRACTITIONER JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM 29 NATURAL STANDARD MONOGRAPH 900 milligrams of dried garlic has been taken by mouth. For cancer aged garlic extract capsules (containing 2.4 milliliters of garlic extract) or 500 milligrams of aged garlic extract has been taken by mouth daily for six to 12 months. Additionally 1 milliliter of aqueous garlic extract per kilogram of weight has been taken by mouth daily for one month. For cirrhosis (liver disease) 250 milligram capsules containing garlic oil (Garlic Pearls Ranbaxy India) have been taken by mouth in two divided doses with meals for nine to 18 months. The daily dose of garlic capsules provided 1-2 grams per square meter of garlic oil. For clogged arteries 900 milligrams of a dehydrated garlic powder tablet (Kwai) has been taken by mouth in single or divided doses for up to four years. A suggested dose for clogged arteries is 3-5 milligrams of allicin (one clove or 0.5-1 gram of dried powder) daily by mouth. For common cold upper respiratory tract infection 180 milligrams of allicin (Allimax) has been taken by mouth daily for 12 weeks. Two capsules containing aged garlic extract (AGE) powder have been taken by mouth twice daily for 90 days. The suggested dose for respiratory infections is 2-4 grams of garlic dried bulb or 2-4 milliliters of garlic alcoholic extract (1 5 45 percent ethanol) taken by mouth three times daily. For cystic fibrosis capsules containing 656 milligrams of garlic oil have been used once daily with evening meals for eight weeks. One garlic capsule has been taken daily for eight weeks. For dental conditions 20 drops of garlic solution (40 milligrams per milliliter) has been used in the mouth three times daily for four weeks. For hair loss 5 percent garlic gel has been applied to the scalp four times daily for three months. For heart disease risk and prevention one tablet of Allicor (150 milligrams of garlic powder) has been taken by mouth two times daily for 12 months. Six to 10 grams of a garlic ether extract has been taken by mouth for three years. For heavy metal lead toxicity capsules containing 400 milligrams of dried powder garlic have been taken by mouth three times daily for four weeks. For high cholesterol 10-7 200 milligrams of garlic has been taken in powder tablet oil extract or allicin form by mouth daily in single or divided doses for up to 7.3 years. For high blood pressure 600-2 400 milligrams of garlic powder (Kwai or Allicor) or aged garlic extract (Kyolic) in single or divided doses has been taken by mouth daily for up to 12 weeks. For Helicobacter pylori infection 4 200 micrograms of allicin (the main ingredient in garlic) daily in conjunction with standard treatment has been taken by mouth for 14 days. Additionally 400 milligrams of Kyolic aged garlic extract plus 2 milligrams of steam-distilled garlic oil has been taken by mouth twice daily for seven years. For oral candidiasis (yeast infection) garlic paste has been applied in the mouth four times daily for 14 days. For a mosquito repellent four garlic capsules as a single dose have been taken by mouth. For peripheral vascular disease 800-900 milligrams of dehydrated garlic (Kwai) has been taken by mouth daily for 12 weeks. For pre-eclampsia (high blood pressure during pregnancy) 800 milligrams of garlic (Garlet 1 000 micrograms of allicin and ajoene) has been taken by mouth daily for up to eight weeks. For sickle-cell anemia (blood cell disorder) 5 milliliters of aged garlic extract has been taken by mouth daily for four weeks. For stomach cancer prevention garlic supplementation for up to 7.3 years (dosage unknown) has been taken by mouth. For systemic sclerosis (thickening of skin) 900 milligrams of dried garlic powder has been taken by mouth for seven days. For a tick repellant 1 200 milligrams of Allium capsules have been taken by mouth daily for eight weeks. For type 2 diabetes 300-900 milligrams of Allicor or a dehydrated garlic preparation (Kwai) has been used in single or divided doses for up to 24 weeks. For warts water-based garlic extract has been applied twice daily on warts. A lipid extract was also applied twice daily on people with warts and corns. Children (under 18 years old) Safety or effectiveness of garlic supplements is unclear in children. For common cold upper respiratory tract infection extended-release garlic tablets (Allicor 600 milligrams) has been taken by mouth over a five-month period. For familial hyperlipidemia (inherited high cholesterol) 900 milligrams of dehydrated garlic powder tablets (Kwai) has been taken by mouth in three divided daily doses. For parasitic infections 5 milliliters of garlic extract in 100 milliliters of water has been taken by mouth in two doses daily or a commercial preparation of 1.2 milligrams has been taken by mouth twice daily for three days. Additionally 8 grams of a garlic infusion has been taken by mouth daily for five days. sitivity to garlic any of its constituents or to other members of the Liliaceae (lily) family including hyacinth tulip onion leek and chives. Allergic reactions have been reported with garlic taken by mouth inhaled or applied to the skin. These reactions have included asthma closing up of the lung airways dryness and splitting of the lips hives inflammation of the intestines and stomach narrowing of the coronary artery and skin inflammation and swelling. Severe reactions may occur including throat swelling and difficulty breathing (anaphylaxis). Fresh garlic applied to the skin may be more likely to cause rashes than garlic extract. Commercially available gloves may not offer adequate protection for the allergic reaction associated with garlic allergy. Side Effects & Warnings Garlic is likely safe when consumed in amounts usually found in foods in non-allergic or non-sensitive people. Garlic is possibly safe when used as a dietary supplement in suggested doses in healthy adults. Garlic is possibly safe when garlic extracts are used on the skin for 1-2 months in the treatment of warts and corns. Garlic may increase the risk of bleeding. Caution is advised in people with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. Garlic may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia and in those taking drugs herbs or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional including a pharmacist and medication adjustments may be necessary. Use cautiously during breastfeeding in people with gastrointestinal disorders or prone to gastric irritation peptic ulcer disease skin disorders or thyroid disorders. Use cautiously when garlic is injected in the blood in people with liver or kidney disease. Use cautiously in people taking agents for the brain agents for the skin agents that widen blood vessels antiretroviral agents (particularly protease inhibitors) blood pressure lowering agents cholesterol-lowering agents agents metabolized by the liver estrogens or thyroid agents. Avoid in people with a known allergy to garlic its parts or other members of the Liliaceae or Alliaceae families including hyacinth tulip onion leek and chives. Avoid garlic applied to the skin in young children or infants and before surgical or dental procedures. Avoid large amounts of garlic during pregnancy. Garlic may also cause acid reflux anorexia Safety Allergies Avoid in people with a known allergy or sen- 30 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 asthma bad breath bleeding after surgery blisters blood pressure reduction body odor botulism (paralyzing illness) bowel obstruction burns to the skin burping change in bacteria in the stomach chest pain chills constipation coughing up of blood darkening of the skin dead tissue decrease in blood clotting time diarrhea difficulty breathing dizziness drowsiness dryness and splitting of the lips eczema euphoria eye hemorrhage during surgery facial flushing fever gas gastrointestinal irritation or burning (including mouth esophagus and stomach) gout heart attack heartburn high white blood cell concentration high heart rate hives hypothyroidism (underactive thyroid) and reduced iodine uptake increased appetite increased colic risk in infants increased eye pressure increased insulin secretion increased sweating inflammation of stomach and intestines inhibition of amyloid production internal bleeding near the kidney itching kidney damage lip inflammation liver damage local irritation low back pain lower cholesterol nausea neurological effects painful urination or excessive large volume of urine pemphigus (blistering of the skin or mucus membranes) redness self-inflicted lesions of the skin skin inflammation sleeping problems suppression of sperm production ulcers uterine contractions vomiting and weight loss. Note Dishes containing generally acceptable doses of raw garlic are unlikely to increase the risk of bleeding before surgery. Pregnancy & Breast Feeding Garlic is likely safe during pregnancy in amounts usually eaten in food based on historical use. However garlic supplements or large amounts of garlic should be avoided during pregnancy due to a possible increased risk of bleeding or stimulation of uterine contractions. Many tinctures contain high levels of alcohol and should be avoided during pregnancy. Garlic is likely safe during breastfeeding in amounts usually eaten in food based on historical use. However some mothers who take garlic supplements reported increased nursing time milk odor and milk consumption. The safety of garlic supplements during breastfeeding is unclear. Colic has been associated with maternal garlic consumption. Garlic in a combination treatment purportedly increased breast milk. Garlic in breast milk has been reported to increase nursing time. monitored closely by a qualified health care professional including a pharmacist. Medication adjustments may be necessary. Garlic may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin anticoagulants ( blood thinners ) such as warfarin (Coumadin) or heparin antiplatelet drugs such as clopidogrel (Plavix) and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin Advil) or naproxen (Naprosyn Aleve). Garlic may interfere with the way the body processes certain drugs using the liver s cytochrome P450 enzyme system. As a result the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert and speak with a qualified healthcare professional including a pharmacist about possible interactions. Many tinctures contain high levels of alcohol and may cause nausea or vomiting when taken with metronidazole (Flagyl) or disulfiram (Antabuse). Because garlic contains estrogen like chemicals the effects of other agents believed to have estrogen-like properties may be altered. Garlic may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure. Garlic may also interact with acetaminophen agents for cancer glaucoma obesity osteoporosis agents for the blood brain heart kidneys intestines skin stomach agents that alter eye pressure agents that alter immune function agents that induce abortion agents that widen or relax blood vessels agents toxic to the liver anthelmintics antibiotics antifungals antiparasitics antiretrovirals antivirals cholesterol lowering agents clofibrate disulfiram docetaxel estrogens fertility agents iodine isoniazid metronidazole nonsteroidal anti-inflammatory agents (NSAIDs) performance-enhancing agents potassium salts thyroid hormones weight loss agents. Interactions with Herbs & Dietary Supplements Garlic may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring and doses may need adjustment. Garlic may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding although this has not been proven in most cases. Garlic may interfere with the way the body processes certain herbs or supplements using the liver s cytochrome P450 enzyme system. As a result the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system. Because garlic contains estrogen like chemicals the effects of other agents believed to have estrogen-like properties may be altered. Garlic may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure. Garlic may also interact with anthelmintics antibacterials antifungals antioxidants antiparasitics antivirals cholesterol lowering herbs and supplements EPA (eicosapentaenoic acid) and fish oil fertility herbs and supplements ginkgo herbs and supplements for cancer glaucoma obesity osteoporosis herbs and supplements for the blood brain heart kidneys intestines skin stomach herbs and supplements that alter eye pressure herbs and supplements that alter immune function herbs and supplements that induce abortion herbs and supplements that widen blood vessels herbs and supplements toxic to the liver performance-enhancing herbs and supplements potassium Pycnogenol selenium thyroid herbs and supplements weight loss herbs and supplements zinc. For a full list of references visit www.naturalpractitionermag.com. Natural Standard Research Collaboration (www.naturalmedicinestherapeuticresearch.com) provides access to the most comprehensive database of high-quality evidence-based systematic reviews on dietary supplements and CAM therapies. This database is a clinical decision support tool that is designed to advise clinicians and researchers on the safety and efficacy of herbs supplements vitamins diets nutrition exercise and complementary practices and modalities. Using a comprehensive methodology reproducible grading scales and the collective expertise of a multi-disciplinary Editorial Board Natural Standard s mission is to provide organizations with access to the highest-quality evidence-based intelligence to make more informed and safer therapeutic decisions. Questions about the database can be directed to (617) 591-3348. Interactions Interactions with Drugs Garlic may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 31 PRACTITIONER CHAT urt N. Woeller DO has been an integrative medicine physician and biomedical autism specialist for more than 15 years offering specialized treatment and testing for individuals with complex medical conditions. He is an international speaker and author of multiple books including Autism--The Road To Recovery Methyl-B12 Therapy for Autism MethylB12 for Alzheimer s Disease and Dementia and 5 Things you MUST Do Right Now To Help With Your Rheumatoid Arthritis. He is also an educator working as a clinical consultant for healthcare practitioners interested in integrative medicine while offering educational opportunities through informational websites and monthly webinars. have spoken at integrative conferences through the United States and internationally on the principles of biomedical intervention for autism including countless hours of online webinars for health practitioners seeking assistance for this special needs community. One additional avenue I have for doctors and parents of special needs individuals is a biomedical education website called Autism Action Plan (www.autismactionplan.com). This provides 24 7 access to articles videos protocols and a Parent Forum full of past questions and answers regarding integrative medicine for autism. I answer questions for members seeking guidance for special needs individuals. There are many health practitioners who are part of this site who seek assistance from me regarding various patient scenarios. Can you describe your specialized treatment testing for autism What is integrative medicine s role The vast majority of individuals with an autism-spectrum disorder have a complex array of underlying health problems such as biochemical imbalances immune problems chronic infections digestive issues etc. In order to determine what medical problems exist various integrative medicine tests need to be performed and then various nutritional and targeted therapies are employed to help the individual. For example food sensitivities play a large role in autism particularly gluten and casein. Therefore two specific tests called a Food IgG and Urinary Peptide are used to determine the immune and chemical sensitivity to these food proteins. Often times when gluten and casein are removed from the diet individuals with autism have improvement in cognitive function language skills and behavior. Also individuals with autism have imbalances in methylation chemistry often warranting the use of methylcobalamin to help with cognitive challenges and language difficulties. Methylcobalamin is a specific form of vitamin B12 that positively influences brain chemistry regarding attention focusing and awareness. Methyl-B12 has been a longstanding integrative medicine therapy for special needs individuals and should be considered by any health practitioner working with the autism community. What is the Organic Acids Test and why is it important for integrative health care practitioners The Organic Acids Test is a urine test from Great Plains Laboratory that evaluates various metabolic markers of biochemical imbalances as well as biotoxins from yeast and bacteria. This test is very comprehensive in that it can detect certain vitamin deficiencies mitochondrial metabolism problems essential fatty acid issues neurochemical imbalances and yeast and bacteria toxicity which are known to create physical and psychological problems. For example the Organic Acids Test measures two biotoxins from clostridia bacteria called HPHPA and 4-cresol. These two toxins are known to inhibit a dopamine converting enzyme which when adversely affected leads to excess dopamine production. This causes oxidative stress in the nervous system and can lead to mental health problems. William Shaw PhD from Great Plains Laboratory has shown that these chemicals are often quite elevated in individuals on the autism-spectrum and those with various mental health problems such as schizophrenia. In my practice I often find these clostridia toxins elevated in my patients and treatment of the clostridia bacteria with either antibiotic and or natural remedies shows great improvement in patients clinical problems. K Kurt N. Woeller DO Phone (951) 461-4800 (Office) E-mail info mysunrisecenter.com Website www.mysunrisecenter.com Q A Please describe your role as an educator for health care practitioners interested in integrative medicine. I have been involved in doctor and patient education for many years. For over 15 years I have actively pursued integrative medicine for my patients. The nature of integrative medicine requires that patients be an active member in their health care regarding understanding how diet and lifestyle choices impact their health. Therefore patient education is key to a successful integrative medicine practice. Through my clinical experience with hundreds of patients the information I have garnered easily transfers over to doctors. Early in my career I presented clinical information for doctors related to adrenal and thyroid dysfunction along with specific information about specialized testing. My role then progressed into one-on-one clinical consulting for specialty labs performing sophisticated testing for chronically ill patients. Over the past three to four years I Q A Q A 32 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Another key part of the Organic Acids Test is measuring oxalate values. Oxalate is a compound found in many foods that when too high can lead to crystal formation in the body and in severe cases kidney stones. Oxalates are known to cause mineral imbalances and lead to body pain. This body pain can be found in the joints muscles and connective tissue and especially during urination as oxalates are excreted via the kidneys. High oxalates are often seen in the autism community where it can lead to behavior problems and increased physical sensitivities. The Organic Acids Test is the best measurement of oxalates available. In my opinion the Organic Acids Test from Great Plains Laboratory is an essential test to perform for any integrative health practitioner. What are the five things everyone must do to help their rheumatoid arthristis Are there natural remedies The main thing with rheumatoid arthritis (RA) is to identify underlying physical stressors such as chronic infections in the digestive system i.e. clostridia bacteria and food sensitivities i.e. gluten. There are many natural remedy options such as curcumin as a natural anti-inflammatory herb but ultimately targeted nutrition needs to be implemented based on integrative medicine testing such as imbalances acquired from Organic Acids Testing. I also advocate doing salivary cortisol testing and comprehensive food sensitivity testing. The adrenals help control inflammation through proper levels of cortisol and adverse reactions to various food proteins can trigger inflammation via autoimmune reactions. There is good evidence that a remedy called Low Dose Naltrexone (LDN) is useful for autoimmune diseases including RA. LDN is a non-toxin immune modulator that helps shift the body away from autoimmune reactivity. Another useful therapy is Minocycline antibiotic. Minocycline plays a role as an anti-inflammatory and current research and that in the past suggests RA can be triggered by an underlying bacterial infection. Minocycline is well-tolerated and cross-sensitive to a number of bacteria. LDN and Minocycline have been shown clinically to give very positive responses when used together. For more information see my book at www.rheumatoidarthritisrecovery.com. What are the triggers for chronic fatigue syndrome How can natural practitioners help There are multiple triggers for chronic fatigue syndrome (CFS). For most Q A people with CFS the breakdown of the hormone and immune complex is at the heart of their problems. This comes about from chronic stressors over many years linked to lifestyle mental and or emotional issues. Because of the link between the hypothalamus-pituitary-adrenal axis and chronic stress people with CFS have poor adrenal function as well as other hormone imbalances. These hormone imbalances lead to faulty cellular metabolism and deficient cell energy output. Often times the fix for CFS involves a vast array of integrative medicine testing including salivary adrenal testing blood chemistry thyroid assessment and an Organic Acids Test. There is usually not just one treatment for CFS but a multitude of possible interventions. The immune system plays a significant role in many patients with CFS as well. Viral infections have been known to trigger CFS and the breakdown of immune function over time can occur with adrenal dysfunction. Therefore identifying immune imbalances as well as chronic infections is key for CFS assessment. Natural medicine (aka. integrative medicine) practitioners are best suited to address the complex needs of people with CFS. Integrative medicine has many more options for CFS such as targeted nutritional therapy herbs detoxification intervention and selective medications as needed based on the clinical response of the patient. CFS is one area of medicine where traditional medicine commonly falls short in helping. Can traditional medicine and integrative medicine work together in finding solutions Traditional and integrative medicine can work very well together. In fact any good integrative medicine practitioner understands that sometimes traditional medicine approaches are necessary for their patients. For example despite the plethora of supplements and herbal remedies available some patients need antibiotic therapy to treat their infections. Also certain patients can obtain positive results with targeted supplement therapy for stress-related conditions such as depression and anxiety. However in some cases the use of traditional psychiatric medication is warranted if integrative medicine therapy is not working. There is definitely room for both in our health care system and one shouldn t be exclusive of the other. Q A Q A JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 33 NATURAL HEALTH STUDIES Nothing Fishy About Plant-based Omega-3 Fatty Acid Health Benefits ncreasing the amount of omega-3s in your diet whether from fish or flax will likely decrease your risk of getting heart disease according to Penn State nutritionists. A substantial amount of evidence exists supporting the heart-health benefits of eicosapentaenoic acid and docosahexaenoic acid (EPA and DHA) marinederived omega-3 fatty acids. However much less evidence exists to demonstrate the positive effects of alpha-linolenic acid (ALA) a plant-based omega-3 fatty acid. The benefits reported for EPA and DHA are stronger because supplements of EPA and DHA were tested and EPA and DHA was the only difference between the treatment and control groups said Jennifer Fleming instructor and clinical research coordinator in nutritional sciences. In contrast in the ALA studies there were diet differences beyond ALA between the treatment and control groups. I EPA and DHA can be found in seafood and fish oil and are often consumed in the form of dietary supplements. ALA is found in flaxseed and its oil vegetable oils and some nuts and is now available in supplement form. EPA and DHA have been available for much longer. Other sources of ALA EPA and DHA are fortified foods such as orange juice eggs peanut butter margarine and bread among others. While there are many other omega-3 fortified foods in the market place most are relatively low in omega-3 fatty acids. Omega-3 fatty acids are considered essential for human health but the body does not produce them--therefore they must be consumed in order to maintain appropriate levels. In reviewing existing literature on the subject the researchers have come to the conclusion that ALA is likely just as effective in preventing cardiovascular disease (CVD) as EPA and DHA have proven to be as reported in the November 2014 issue of Advances in Nutrition. Our understanding of the cardiovascular disease benefits of ALA has advanced markedly during the past decade said Penny Kris-Etherton Distinguished Professor of Nutrition. Based on the current evidence ALA decreases CVD risk. Fleming and Kris-Etherton believe that dietary recommendations should be amended to increase the amount of ALA consumed but note that randomized controlled clinical trials need to be conducted in order to determine the amount recommended. Heart disease is the leading cause of death in the country said Fleming. Learning what you can do to prevent heart disease is important and relevant for everybody. (Source Advances in Nutrition-- November 2014) Discussing Alternative Medicine Choices for Better Health Outcomes n the field of medicine there has often been a divide between those who focus on modern medicine and those who prefer alternative practices. But Pediatrician Sunita Vohra is a firm believer there should be room for both. A new study from Dr.Vohra a professor in the Faculty of Medicine & Dentistry s Department of Pediatrics at the University of Alberta (Canada) and a pediatric physician for Clinical Pharmacology with Alberta Health Services is giving insight into the use of alternative medicine by pediatric cardiac patients and how effective they are seen to be. We wanted to know if the use of alternative therapies helped or not and we wanted to know if it hurt them or not she said. The study published in the journal CMAJ Open examined the use of alternative therapies such as multivitamins minerals chiropractic care and Aboriginal healing in 176 patients at the Stollery Children s Hospital in I Edmonton Alberta and the Children s Hospital of Eastern Ontario (CHEO) in Ottawa ON Canada. It found 64 percent of patients at the Stollery Children s Hospital reported using complementary and alternative medicine products and practices compared with just 36 percent at CHEO. Of those patients Vohra said most had no regrets about their choices. The vast majority felt that they had been helped by the complementary therapy that they took and it was extremely unusual for them to report that they felt an adverse event had occurred because of it. The study also found one third of patients and their families did not discuss the use of alternative medicines with their physicians. Dr. Vohra believes it shows that patients may be reluctant to discuss their choices if they re not sure how it will be received by health care providers. That decision could have important health consequences said Dr. Vohra who also serves as director of the Complementary and Alternative Research and Education (CARE) program at the University of Alberta and that patients discussing alternative therapies with health professionals is vital in order for them to make informed choices. There may be some therapies that help children feel better but there may be others that unbeknownst to the family cause interaction between a specific natural health product and a prescription medicine she said. In that setting instead of helping the child get better harm may actually be happening. Dr. Vohra stresses the need for open communication and says children s hospitals in Canada need to do a better job of providing information to patients looking at other avenues to health. That communication is essential because the health care providers and the parents-- together we are a team. And everyone s hope is for that child s better health. (Source CMAJ Open-- October 2014) 34 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Tea Citrus Products Could Lower Ovarian Cancer Risk New Research Finds ea and citrus fruits and juices are associated with a lower risk of developing ovarian cancer according to new research from the University of East Anglia (UEA). The research reveals that women who consume foods containing flavonols and flavanones (both subclasses of dietary flavonoids) significantly decrease their risk of developing epithelial ovarian cancer the fifth-leading cause of cancer death among women. The research team studied the dietary habits of 171 940 women aged between 25 and 55 for more than three decades. The team found that those who consumed food T and drinks high in flavonols (found in tea red wine apples and grapes) and flavanones (found in citrus fruit and juices) were less likely to develop the disease. Ovarian cancer affects more than 6 500 women in the U.K. each year. In the United States approximately 20 000 women are diagnosed with ovarian cancer each year. Professor Aedin Cassidy from the Department of Nutrition at UEA s Norwich Medical School led the study. This is the first large-scale study looking into whether habitual intake of different flavonoids can reduce the risk of epithelial ovarian cancer she said. We found that women who consume foods high in two sub-groups of powerful substances called flavonoids--flavonols and flavanones-- had a significantly lower risk of developing epithelial ovarian cancer. The main sources of these compounds include tea and citrus fruits and juices which are readily incorporated into the diet suggesting that simple changes in food intake could have an impact on reducing ovarian cancer risk Cassidy continued. In particular just a couple of cups of black tea every day was associated with a 31 percent reduction in risk. (Source American Journal of Clinical Nutrition-- October 2014) Taking Antibiotics During Pregnancy Increases Risk for Child Becoming Obese study released by Columbia University s Mailman School of Public Health found that children who were exposed to antibiotics in the second or third trimester of pregnancy had a higher risk of childhood obesity at age 7. The research also showed that for mothers who delivered their babies by a Caesarean section whether elective or non-elective there was a higher risk for obesity in their offspring. Study findings are published online in the International Journal of Obesity. Although previous studies have shown that antibiotics administered early in life may be associated with increased risk of obesity in childhood this is the first study reporting that maternal antibiotic use in the second or third trimester of pregnancy increases the risk of offspring obesity. Antibiotics affect microbes in the mother and may enter fetal circulation via the placenta. Researchers are beginning to understand that the bacteria that normally inhabit our colon have important roles in maintaining our health and imbalances in these bacterial populations can cause a variety of illnesses. Disturbances in the normal transmission of bacteria from the mother to the child are thought to place the child at risk for several health conditions including obesity. The study is based on data of healthy non-smoking pregnant women who were recruited for the Northern Manhattan A Mothers and Children Study from prenatal clinics at New York-Presbyterian Hospital and Harlem Hospital Center between 1998 and 2006. Of 727 mothers enrolled in the study 436 mothers and their children were followed until 7 years of age. Of these 436 children 16 percent had mothers who used antibiotics in the second or trimester. This work is part of the Columbia Center for Children s Environmental Health s efforts to understand how to promote healthy growth and development through out childhood and adolescence. The children exposed to antibiotics in this timeframe had an 84 percent higher risk of obesity compared with children who were not exposed. Our findings on prenatal antibiotics and risk for offspring obesity are novel and thus warrant replication in other prospective cohort studies said Noel Mueller PhD postdoctoral research fellow at Columbia University s Mailman School of Public Health and Institute of Human Nutrition. If these findings hold up they suggest new mechanisms through which childhood growth trajectories are influenced at the earliest stages of development. Our findings should not discourage antibiotic use when they are medically needed but it is important to recognize that antibiotics are currently overprescribed. Independent of prenatal antibiotic usage delivery by Caesarean section was also associated with a 46 percent higher risk of child- hood obesity. The researchers controlled for maternal age ethnicity birth weight sex breastfeeding in the first year and gestational antibiotics or delivery mode. Our findings are consistent with a series of papers that looked at data on Caesarean section. While earlier studies suggested that childhood outcomes differ by whether the Caesarean section was elective or non-elective we did not observe such evidence said Andrew Rundle DrPH associate professor of Epidemiology at the Mailman School of Public Health. Thus our findings provide new evidence in support of the hypothesis that Caesarean section independently contributes to the risk of childhood obesity. Similar to antibiotic use during pregnancy Caesarean section birth is thought to reduce the normal transmission of bacteria from the mother to the child and to disturb the balance of bacteria in the child. Strategies to reduce medically unnecessary C-sections and to provide the infant with health promoting bacteria after C-section need to be researched noted Dr. Mueller. Further research is needed on how mode of delivery antibiotic use during pregnancy and other factors influence the establishment of the ecosystem of bacteria that inhabit each of us said Dr. Rundle. This research will help us understand how to create an early platform to support the healthy growth and development of children. (Source International Journal of Obesity-- November 2014) JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 35 NATURAL HEALTH STUDIES PPIs Decrease Diversity in Gut Microbiome Increase Risk for Complications B efore reaching for that daily antacid one may consider what it s doing to the trillions of bugs living in your gut. A new Mayo Clinic study in the open access journal Microbiome shows that people who regularly take proton pump inhibitors (PPIs) have less diversity among their gut bacteria putting them at increased risk for infections like clostridium difficile and pneumonia in addition to vitamin deficiencies and bone fractures. Evidence has been mounting for years that long-term use of proton pump inhibitors poses increased risks for a variety of associated complications but we have never really understood why said John DiBaise MD a Mayo Clinic gastroenterologist and senior author on the study. What this study does for the first time is demonstrate a plausible explanation for these associated conditions. The gut microbiome consists of trillions of bacteria. Rather than causing dis- ease most of these bacteria are friendly and aid in everything from digestion and vitamin synthesis to immune system regulation and possibly mood stabilization. Diet genetics and environmental exposure all play a role in maintaining a healthy microbiome which is critical to overall wellness said Dr. DiBaise. Significant changes to the microbiome like those caused by PPIs can put people at risk for over-colonization by such undesirable species as clostridium difficile. PPIs are primarily used to treat ulcers and acid reflux and include the generic names omeprazole pantoprazole esomeprazole lansoprazole rabeprazole and dexlansoprazole. Many epidemiological studies have linked PPIs to nutritional metabolic and infectious disorders despite the class of drugs long history of safety and efficacy. Specifically their prolonged use has been associated with iron and vitamin B12 deficiencies hypomagnesemia osteoporo- sis-related fractures small intestinal bacterial overgrowth and communityacquired pneumonia. The Food and Drug Administration has issued several safety communications about use of high-dose PPIs (available through prescription) and long-term use at any dose including overthe-counter medications. Safety implications of the study have yet to be determined and patients should consult a qualified medical professional before changing any drug regimen noted Dr. DiBaise. We re not saying people should stop taking their regular antacids despite the many health risks associated with PPI use they have an extensive track record of safety when used as directed he said. What we are saying is that the medical and research communities should consider these medications in the context of the patient s microbiome. This is an area that needs further study. (Source Microbiome-- November 2014) Breathe Easier Get Your Vitamin D A sthma has become more common in recent years. While there is no known cure asthma can be managed with medication and by avoiding allergens and other triggers. A new study by a Tel Aviv University (TAU Israel) researcher points to a convenient free way to manage acute asthmatic episodes--catching some rays outside. According to a paper recently published in the journal Allergy measuring and if need be boosting vitamin D levels could help manage asthma attacks. The research conducted by Dr. Ronit Confino-Cohen of TAU s Sackler Faculty of Medicine Meir Medical Center and the Clalit Research Institute and Dr. Becca Feldman of the Clalit Research Institute drew on the records of millions of patients and used physician diagnoses rather than self-reports for evidence of asthma episodes. Dr. Confino-Cohen and her team of researchers analyzed the medical records of nearly four million members of Clalit Health Services Israel s largest health care provider. The vitamin D levels of 307 900 people were measured between 2008 and 2012. Researchers also took into account key predictors of asthma such as obesity smoking and other chronic diseases. Of some 21 000 asthma patients in Israel studied those with a vitamin D deficiency were 25 percent more likely than other asthmatics to have had at least one flare-up in the recent past. The researchers found that vitamin Ddeficient asthmatics were at a higher risk of an asthma attack. Uncontrolled asthma was defined as being prescribed at least five rescue inhalers one prescription of oral corticosteroids or visiting the doctor for asthma at least four times in a single year. Our results add more evidence to the link between vitamin D and asthma suggesting beneficial effects of vitamin D on asthma exacerbations said Dr. ConfinoCohen. We expect that further prospective studies will support our results. In the meantime our results support a recommendation for screening of vitamin D levels in the subgroup of asthma patients who experience recurrent exacerbations. In those with vitamin D deficiency supplementation may be necessary. Based on the findings the researchers recommend that people whose asthma cannot be controlled with existing treatments have their vitamin D levels tested. For those with a vitamin D deficiency supplements may make sense. This study provided an exceptional opportunity to research asthma. I received a research grant from Clalit Health Services which provided us with the opportunity to use their very large database and to conduct the study with the professional staff of Clalit Research Institute said Dr. Confino-Cohen. We anticipate further prospective research that will support our findings and open a new treatment modality to the population of uncontrolled asthmatics. (Source Allergy-- December 2014) 36 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 Theory Behind Increasing Fruit and Vegetable Consumption Does Not Determine Reality W hen it comes to increasing fruit and vegetable consumption in children theory does not necessarily determine reality according to experts at the USDA ARS Children s Nutrition Research Center at Baylor College of Medicine and Texas Children s Hospital. In a report that appeared in the Journal of Nutrition Education and Behavior researchers found that interventions based on behavioral change theory were not related to increased fruit consumption in children. The goal of our study was to assess whether interventions that were based on theory were more effective than non-theory interventions in increasing fruit and vegetable intake said Dr. Cassandra S. Diep postdoctoral fellow at Baylor and first author of the paper. Health professionals devote their careers to understanding how to help people change their health behaviors and the golden rule has been that interventions should be based on theory because doing so will make them more effective but there is no research to justify this. For example social cognitive theory and the theory of planned behavior are two health behavior theories that provide researchers with constructs and pathways that if targeted will most likely lead to a change in behavior. The base idea is that if the researcher can change attitudes social norms or other constructs they can change behavior. Dr. Diep and colleagues did a systematic literature review and meta-analysis of studies over the past 25 years to determine whether interventions had an effect on fruit and vegetable intake in children and whether the interventions based on theory were more effective than those without theory. We found that overall interventions based on behavioral theory had a small to moderate effect on improving a child s fruit and vegetable consumption she said. Once you controlled for study quality we found that theory was no longer related to fruit consumption or combined fruit and vegetable consumption only vegetable consumption. There was a positive effect on vegetable consumption but the effect size was quite small. This suggests that theory may have a role in increasing intervention effectiveness but the effect sizes have not been large and poor study quality may be the underlying reason for lack of effect said Dr. Diep. Dr. Diep noted that those designing interventions need to be more meticulous when creating them. If they want to use theory they have to make sure that the theory they use is right for the population that they are targeting and right for the behavior that they are targeting she said. There are also standard theories that people like to use because everybody uses them but they may not be the most applicable to that specific intervention. (Source Journal of Nutrition Education and Behavior-- November-December 2014) Study Self-acupressure Can Help Constipation A pproximately 19 percent of North Americans suffer from constipation with the digestive condition being more common among women nonwhites people older than 60 those who are not physically active and the poor. The costs are significant. Hospital costs to treat the condition were estimated at 4.25 billion in 2010 alone. Constipation can also lead to depression lower quality of life and a drop in work productivity. Treatments include use of laxatives increased intake of dietary fiber and fluid and exercise. But new research from the University of California Los Angeles (UCLA) Center for East-West Medicine published online in the Journal of General Internal Medicine shows how Eastern and Western medicine can blend to find solutions to this common medical problem. In a randomized clinical trial 72 percent of participants said that perineal self-acupressure a simple technique involving the application of external pressure to the perineum--the area between the anus and genitals-- helped them have a bowel movement. The research suggests that all primary care and general internal physicians should consider this technique as a first line intervention together with conventional treatment said Dr. Ryan Abbott the study s principal investigator and a visiting assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA. Constipation is very common and can have debilitating symptoms said Dr. Abbott who is also a researcher and educator with the East-West center. But patients can perform this simple intervention themselves to treat their own constipation and improve their quality of life. It can also help to limit health care costs and excessive medication use. The researchers recruited 100 patients nine of whom dropped out during the trial age 18 and older whom met the established criteria for functional constipation. Among these criteria are that they have fewer than three defecations per week and that for at least 25 percent of the their bowel movements they Strain during defecation Have lumpy or hard stools Experience a sensation of incomplete evacuation Experience a sense of obstruction or blockage Use manual maneuvers such as digital evacuation After researchers gave patients just three to five minutes of instruction patients were encouraged to perform the exercises on their own for four weeks when they felt the urge to defecate. Patients reported using the technique three to four times a week on average. The self-acupressure broke up hard stools relaxed muscles and stimulated nerves responsible for bowel movements. Among the other findings 72 percent said the technique helped them break up soften or pass stools. 54 percent claimed it helped avoid hemorrhoids or lessen the severity of existing hemorrhoids. 82 percent said they would continue using the technique. 72 percent said they would recommend the technique to family and friends. This unique self-administered acupressure treatment for constipation is just one example of how an integrative approach to medicine helps patients and is cost-effective too said Dr. Ka-Kit Hui Wallis Annenberg Endowed Chair in Integrative East-West Medicine at UCLA and founder and director of the UCLA Center for EastWest Medicine. Utilizing both Eastern and Western approaches helps create a new paradigm of medicine that combines the best of both worlds. (Source Journal of General Internal Medicine-- November 2014) JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 37 NATURAL MARKETPLACE NATURAL MARKETPLACE PROVIDES INFORMATION ABOUT NEW PRODUCTS AVAILABLE TO THE NATURAL HEALTH CARE INDUSTRY. ALL STATEMENTS CLAIMS AND PRODUCT INFORMATION ARE PROVIDED BY THE MANUFACTURER. NATURAL PRACTITIONER DOES NOT ENDORSE ANY PRODUCTS INCLUDED IN NATURAL MARKETPLACE OR ATTEMPT TO CORROBORATE ANY CLAIMS MADE BY THE MANUFACTURER. To have a new product included in Natural Marketplace please send a press release and photograph to Natural Practitioner by e-mail to DanielB VRMmedia.com The Hand Beverage GREAT BARRINGTON MA--The most holistic skin care products by Jane Iredale has just released its newest product HandDrink. The new hand cream is a SPF 15 broad-spectrum formula that is ultra-hydrating and never greasy. Recommended by The Skin Care Foundation as an effective sunscreen the 29 2-fl. oz. 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For more information call (888) 958-7854 or visit www.sukiskincare.com. Smiling Pups CENTENNIAL CO--Indigenous Pet Products new formulation of Pegetables Nature s Dog Chews are safe easily digestible dog treats to promote dental health. The new canine snack helps to clean teeth and freshen breath in a safe and effective way. They are specifically formulated with vegetables such as sweet potatoes peas and carrots for added nutrition and are free of corn wheat grain and gluten for healthy and happy dogs. For more information call (800) 652-4732 or visit www.indigenouspet.com. An Age-less Kiss TORRENCE CA--Murad s Age Reform collection has recently added Rapid Collagen Infusion for Lips. The new lip treatment reduces the appearance of aging and restores youthful structure. The clear serum promotes collagen and elasticity naturally while smoothing fine lines and wrinkles. 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For more information call (800) 33-MURAD or vist www.murad.com. 38 NATURAL PRACTITIONER WWW.NATURALPRACTITIONERMAG.COM JANUARY FEBRUARY 2015 BOOKSHELF Conquering Cultural Stress The Ultimate Anti-Aging Secret Author Howard Murad MD Pages 216 Price 22.95 Publisher Wisdom Waters Press Contact (949) 254-3214 Conquering Cultural Stress The Ultimate Anti-Aging Secret by board-certified dermatologist trained pharmacist associate clinical professor of medicine at the Geffen School of Medicine UCLA (University of California Los Angeles) founder of Murad Inc. and author of five previous books Howard Murad MD FAAD magnifies how harmful today s society really is to both our mind and body. After extensive research he defines cultural stress as the stress of over-connected modern living on the cellular water levels- the key markers of all aging processes and disease. The book explains that going about our daily lives with today s technology pressure and hunger for success has lead to extreme stress. To reverse the damage Dr. Murad is positive that everyone has the potential to look and feel younger and to live healthier happier and more rewarding lives. In order to do so he has constructed a custom-made guide backed up by research and his own personal experience from treating more than 50 000 patients. In Conquering Cultural Stress The Ultimate Anti-Aging Secret readers will learn his consolidating strategy to help protect and restore cellular water levels in order to overcome the assault due to cultural stress. His advice is for people to bring out their inner toddler to regain youth. The pages unfold 365 lifestyle insights one for everyday of the year hand chosen from his vast library of insights used to help his own Inclusive Health program clients. The book also provides readers with delicious healthy cell-hydrating recipes to further support the body and mind. The MD Factor Diet Author Caroline J. Cederquist Pages 264 Price 22 Publisher BenBella Books Contact (212) 584-4314 The MD Factor Diet by Caroline J. Cederquist MD discusses metabolic dysfunction (MD) which occurs when your metabolism slows down and stores fat. Dr. Cederquist is a board certified expert on weight loss and nutrition with her practice located at the Cederquist Medical Wellness Center (Naples FL). She believes that everyone is at risk with more than 89 percent of people who are overweight have the MD Factor without even realizing it. When trying to identify whether or not you in fact have the MD Factor is easy. You become hungrier in the morning crave sweets and carbohydrates and have insomnia. It s a lot easier to lose weight if you aren t constantly hungry cranky weak and craving sugar she said. Her book explains the causes of change in metabolism which includes genetics aging medications nutrition vitamin deficiency and belly and visceral fat. The old approach to weight loss taking in fewer calories than you expend doesn t consistently work anymore she said. Therefore Dr. Cederquist created a physician s proven diet promoting a healthy metabolism. The diet consists of a three-step phase focusing on protein which she recommends 100-120 grams for women and 120-140 grams for men. The MD Factor Diet discusses actions and maintenance exercise the impact of genetics and the affects of alcohol on ones diet. JANUARY FEBRUARY 2015 WWW.NATURALPRACTITIONERMAG.COM NATURAL PRACTITIONER 39 CONFERENCES AND EVENTS February 19-21 Integrative Healthcare Symposium New York NY Physicians Naturopaths Osteopaths Chiropractors Dieticians Licensed Nutritionists Nurse Practitioners Registered Nurses Physician Assistants and Integrative Medicine CAM Program Directors are encouraged to attend this year s trade fair. The event will be categorized by the following Environmental Health Nutritional Science Brain Mind & Mood and Integrative Nursing. For more information visit www.ihsymposium.com. April 10-12 Southwest Conference on Botanical Medicine Tempe AZ Topics such as Alternatives to Common Psychiatric Medications The Cytokine Connection to Insomnia Clinical Uses of Cannabinoid Compounds and Working with PTSD are only a handful of topics discussed at this event. Natural practitioners students and physicians can register in early March for the natural medicine conference. Registration includes numerous timely topics and a team of herbal experts to educate attendees. For more information visit www.botanicalmedicine.org. May 1-3 59th Annual NorthWest Naturopathic Physicians Association Convention Seattle WA Physicians medical practitioners and students can register online for the annual event. Registration includes conference lunches on Friday and Saturday as well as the banquet dinner and dance on Saturday night. Live entertainment will follow the banquet. Speakers will be announced in the near future. For more information visit www.nwnpc.com. May 29 June 1 Medicines from the Earth Herb Symposium Black Mountain NC Registration for this spring conference will be April 14 2015 for all natural practitioners medical practitioners physicians and students. Attendees will learn about topics such as omega-3s and mental health early childhood mental health prevention and treatment of skin disorders and more. There will be a variety of herbal experts discussing today s market and new innovations. For more information visit www.botanicalmedicine.org. August 5-8 AANP Annual Conference 2015 Oakland CA The American Association of Naturopathic Physicians hosts their 30th annual conference and invites naturopathic doctors and students licensed acupuncturists and doctors of osteopathy to register and attend this year s event. Dr. Tori Hudson will lead the event that brings together participants and attendees to interact and network while learning about the most up-to-date information in natural medicine. For more information visit www.naturopathic.org. December 11-13 The American Academy of Anti-Aging Medicine (A4M) Las Vegas NV The American Academy of Anti-Aging Medicine (A4M) hosts their 23rd annual World Congress covering topics including anti-aging regenerative and aesthetic medicine. The conference invites physicians scientists and members of the public on biomedical sciences breaking technologies and anti-aging issues and will learn from physicians health practitioners scientists governmental officials and members of the general public representing more than 110 nations. Attendees will learn advancements in technology helping to detect prevent and treat related diseases and will promote research into methods to retard and optimize the human aging process. For more information visit www.a4m.com. ADVERTISER INDEX ADVERTISER America s Finest Inc. Carlson Laboratories Inc. Charak Pharma Pvt. Ltd. DaVinci Laboratories of Vermont Emerson Ecologics Fairhaven Health LLC Kyowa Hakko USA Mushroom Wisdom Probiotics Intl. Ltd. 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