Healthspan is more important than Lifespan

 

Longevity is the big buzzword these days.  There is no end to humanity’s search for the magic elixir of prolonged life or even immortality.  With the continuing discoveries and exponential growth of life science technologies and fuelled by increasing computing power, we are hurtling headlong into the unknown of cracking the code of aging and death.  This is certainly not a bad thing but we do need to take pause and to ask the question of what is the point of life extension if  we are not living well, at our highest level of vitality!

What is health span?  Its difficult to define as everyone’s definition of health is not necessarily the same.  We can safely say that it is the period of one’s life that is free from any serious disease or debilitating illness that impacts our daily living. Its important to note that although we have made significant gains in life expectancy over the past century, we have not been that successful in delaying the onset of most of the common diseases of aging.  This means that although we are living longer, we living longer with disease.  In order for us to be truly compressing morbidity or increasing our relative amount of health span we are going to have to “delay” the physiologic aspects of aging.  This is going to require both major scientific breakthroughs but more importantly, implementing what we already know is true – which is that improving lifestyles, behaviours, communities and socioeconomic determinants of health can significantly increase both lifespan and healthspan.  Its easy to lose sight of the fundamentals in favour of new technology which we hope will save us.  This is shortsighted.  People are not living to their highest health or life potential not because they are lacking a pharmaceutical wonder drug (or natural  supplement for that matter) that slows down or turns off the aging process but because we haven’t optimized environmental conditions (internal and external) which allows optimal health to be the emergent property.

There are many determinants for what one would call health span.  In order to live well at our highest vitality, free of disease ideally, we need a body, a mind,  that has the functional capacity to do what we want it do – free of pain, but also a good level of stress resilience (to deal with what life has in store for us), sense of purpose and meaning, love and connection.  It is very difficult to live with a good quality of life without optimizing all those factors. This is the foundation.

To increase our health span relative to our lifespan we then need to delay the onset of the diseases of aging.  We are understanding much more about the molecular basis of lifespan and there is growing evidence that dietary nutrients (kind, quality and amount), caloric restriction/intermittent fasting, exercise and pharmacologic interventions  (metformin, rapamycin)  seem to be able to modulate key pathways involved in nutrient sensing (AMPK, mTOR), autophagy (cellular renewal), inflammation and senescence (cell death). Much of this science is very promising but still very new. Only time will tell.

I would say ultimately though, it is not about a longer lifespan or even health span that really matter but about living well in full vitality with a sense of purpose, love and connection.  This is what we call Whole human health.  Health ultimately is about wholeness at the deepest level – not just a perfectly functioning body and mind. This wholeness emerges from integration.   We have to integrate all these levels – from cellular biochemistry to the biologic networks of organ systems, to the way we perceive and process information, to the way we respond to our environment (consciously and unconsciously), to our relationship to ourselves, to the connection with others and to nature.  It all starts with awareness.

Join Dr. Christie and myself for a deep dive into these questions of what is true health and wellness as well as reviewing the latest scientific evidence for how we can live optimally well during our upcoming retreat Whole Human Health at the Hollyhock Retreat Centre on Cortes Island this September.

 

https://hollyhock.ca/p/919/whole-human-health-functional-medicine-2-0/

 

Whole Human Health

Ultimately, what is health?

The WHO (World Health Organization) defines it as the following:

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

Health is not merely the absence of disease.  It is a positive asset that enables us to fulfill our human potential.  Without health – it is hard for us to reach the higher levels of Maslow’s hierarchy of needs.  It is the foundation of the pyramid upon which everything is built upon.

Health is wholeness – integrated at every level – from a cellular to whole being.  What constitutes cellular “well-being one might ask?  The cell is our basic unit of function.  It is actually like a computer that is constantly waiting for inputs/information.  Based on the information it receives, it responds by translating the DNA, making proteins, enzymes and other molecules to maintain homeostasis (balance).  The cell is constantly sensing and responding to the environment.  What happens at the cellular level happens at every level of the organism from a tissue, organ, organ system and finally whole person level.

So health is the ability to appropriately sense changes in the environment and make adaptive changes.  The ability for an organism to self-regulate is essential not only to survive but to thrive!  Sensing on every level is dependent on being able to have sufficient balanced sensitivity and being able to interpret/discern the message/information.  Too little sensitivity means that we will fail to pick up signals that might be important and too much sensitivity can result in over stimulation and usually increasing resistance.  This happens at the receptors within the cell, on the cell surface membrane, organ system sensing systems (for carbon dioxide, blood oxygen levels, blood glucose etc.) to nervous system (our senses), our immune system and how we process information from a psychological level as well.  What information, what messages are we inputting into our cellular computer, nervous system, whole person?  Are we conscious about the quality of this information that we expose ourselves to and the resultant downstream effects?

How do we balance our sensitivity set point so that we can pick up the signals from the noise but not be overwhelmed by the noise.  This is where the practices of mindfulness, meditation, yoga, Tai chi, Qi gong of the Eastern Wisdom traditions have much to teach us.  In this world of too much information,  too much sensory overload, being on-line all the time – our nervous systems are losing the ability to be sensitive and discerning at the same time.  This ‘noise’ is causing illness.  We need to balance this by consciously choosing to create space, to subtract, to distill, to edit what is truly important, to quiet down the mind/body noise to that we can connect to something deeper.

The science of epigenetics tells us that our phenotype (which is the observable composite of physical characteristics) is determined by the interaction between our genes and the environment.  What this tells us is that how we live each and every day – what we eat, how we move, how we sleep, ow we perceive the world affects our biochemistry at a DNA level.  The foundations of health need to address all of these.  Lifestyle medicine should always be the first treatment before any drugs or surgeries unless it is an acute illness that requires prompt intervention.  Precision medicine using “omic” molecular technologies (genomics, proteomics, metabolomics, microbiome) will help us understand our biochemistry and physiology like never before and promises truly personalized medicine. But this will not necessarily give you optimal, vital, radiant, exuberant health which is what we all want!

Health is much more than an optimal physiologic state.  Beyond the bottom part of the pyramid, we need safety, social connection, confidence, achievement and self-actualization.  Fundamental to this development is deep sense of knowing oneself and a radical self -acceptance of who we really are and the ability to compassionately observe our patterns of behavior, self-delusion and escape.  A recognition that we are already whole.  We are not broken.  Discomfort, illness, pain are pathways to lead us to observe and learn and ultimately to become more integrated selves.

Whole Human Health is firstly about recognizing our own innate radiant essence and our own innate body intelligence/wisdom.  These core beliefs than translate and manifest as our behaviors.  We cannot sustainably change behaviours without transforming the underlying core beliefs. The journey to health is all of this…

Health is about being in touch with this essence of being a human being.

Please join Dr. Christie and myself on an experiential journey of whole person health at Hollyhock in September 2019.

For more details: https://hollyhock.ca/programinfo/cheng-christie/

 

Precision Medicine – The Molecular You

There is a revolution that is underfoot that is going to change how we understand our bodies, approach our health and how medicine will be practiced.

This coming revolution is being powered by a super-convergence of technology and empowered consumers.  Advances in biotechnology now allows us to sequence your genome in a few hours, analyze hundreds of proteins and metabolites from a drop of blood.  We can even describe the ecology of your of poop!  Coupling this with the exponential increases in computing power, data storage and wearable devices which can now measure real time physiologic variables and you have a convergence of technologies which are going to change medicine.

Precision Medicine is “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment and lifestyle for each person” (https://ghr.nlm.nih.gov/primer/precisionmedicine/definition).  This is in contrast with the current  paradigm of “one-size-fits-all approach”.  We know now that every one is biochemically unique.  We need to move from medicine of the average to medicine for the individual.  Within each individual there are thousands of genetic and metabolic variations.  We are all mutants, outliers in some aspect.  This is actually good for the most part because because many of these mutations may confer some of biologic survival advantage.

 

“Medicine is for real people.  Statistical humans are of little interest” – Dr. Roger Williams.

The molecular you is the sum total of all the molecules in your body and how they interact with each other.  As we begin to map these out, we are essentially writing an operator’s manual for our body which as it turns out we never got.

The omic technologies of genomics, proteonomics, metabolomics and microbiomics are the foundations of understanding the molecular you.  Genomics is the study of our DNA – our blueprint you might say.  Proteonomics is the study of proteins that have been made from the translation of DNA.  We can now measure hundreds of proteins at once using mass spectrometry.  The complete array of proteins at a given point in time is a snapshot of how your DNA is being translated. Metabolomics is the science of the unique chemical fingerprints of cellular processes.  The power is in the combination of this multi-layered data set.  We have decoded the human genome a while ago now and it did not herald a massive transformation in healthcare.  The reason is because the DNA is only the blueprint.  It doesn’t tell us what is actually built or translated.

What is the promise of all of this information? It will tell us what diseases are you more at risk for and what we can do minimize our risk.  It will tell us how to correct imbalances before they manifest into disease.  It will tell us what medicines to take and which ones not to take.  It will tell us what we individually should eat or not eat.  It will tell us if certain lifestyle changes are changing our biochemistry or not.

Most of our current lab testing measures only a few markers that usually can only indicate disease when it is clinically evident (obvious symptoms).  Most chronic diseases which represents the biggest burden of illness certainly in the developed world have a long latency period.  It often takes many years from initiation of a condition before it manifests into obvious symptoms and detectable disease.  For example, atherosclerosis (hardening of the arteries which leads to heart disease and stroke) starts 10 – 20 years before someone has any symptoms.  The promise of molecular testing is that we can begin to detect patterns of system imbalances many years before and this will give us a head start to correct them.  If we are able to correct the imbalances far enough ahead, we may be able to avert getting the disease all together.  This is upstream medicine rather than downstream medicine when we treat disease at its end manifestations.

However, it is early days yet for this technology.  We have much to learn about how significant a particular molecular pattern or signature might be and what specifically we can do to change it.  We will need enough data from enough people to pick up the signals from the molecular noise.  For diagnosis, we will need ensure that the test is sensitive and specific enough to rule in or out disease without having too many false positive or falsely negative tests that will create anxiety and unnecessary testing, interventions and possible harm.

Ultimately, the ability to understand our bodies and mind at a molecular level is going to empower us to make better and better decisions about our health than we ever have been able to until now.  But the totality of a human being is much greater than the sum total of our measured molecules.  So, in order for this technology to truly transform our health, we will need to be able to translate molecular data into real actionable insights and to combine this with conscious awareness and a deep understanding of our inter-connectivity.

For more information about molecular testing:

http://www.molecularyou.com

 

The Future of Medicine – An Integrative Vision

Medicine is undergoing a major paradigm shift from a reactive, organ based diagnosis and disease management system to an engaged, proactive, molecular based systems approach.  This is being called “4P Medicine: Personalized, Predictive Preventive, Preventive and Participatory.
This new medicine is emerging from the rapidly growing new science of systems biology including the study and application of genomics, proteomics, metabolomics and the microbiome.
The super-convergence of  “omics”, new computational tools and an increasingly engaged and knowledgeable population who are using ever more sophisticated biometric tracking devices and learning from each other through social networks is fueling this revolution.

The promise of the new “omic” technology is nothing short of ushering in a whole scale revolution in medicine.  If you really think about it, we don’t really understand the underlying mechanism for many common diseases.  Take hypertension, diabetes, asthma, Alzheimer’s etc., do we really understand the underlying pathophysiologic mechanisms that are in play in a given individual?  Why does one person manifest a disease at a particular point in time and another not?  We are beginning to understand that it is the complex interactions between your genes and the environment that leads to a certain set of biochemistry/physiology which then translates to a given expression of functioning (phenotype).  This phenotype changes with changes in the environment (epigenetic influences).  Dr. Jeffrey Bland writes about this eloquently in his latest book “The Disease Delusion”.

You change your environment (which includes the sum total of what your mind/body/spirit is exposed to) and you change your DNA expression which changes who you are!

Using “omic” technology we are going to be able to better understand this complex gene-environment interaction as never before.  The ability to analyze your DNA for your genetic tendencies plus the resulting protein expression and downstream arrays of hundreds of metabolites, including an understanding how your micro biome (ecology of gut bacteria) might be influencing all this – will begin to give us a picture of what is really going on in a given individual.  This will in turn give us a better chance of correcting these imbalances at a root level to achieve more like what a cure is rather than symptom management.

We tend to have a never-ending fascination with technology (there is nothing wrong with this at all) but we should be wary about continuing down the reductionist rabbit hole and to not forget that the total is much greater than the sum of the different parts.  Even if we think we can measure everything there is to know about a human being, there will be infinitely more that we cannot quantify in terms or numbers, base codes of DNA etc.

What we need is a vision of the Future of Medicine that includes a balanced view of the new technology but calls us to remember that the “molecular/digital you” is not and never will be the same as the “human you”.  An integrative view includes an ecological whole person approach that understands that our health is not separate from anyone or anything else, but is part of an interconnected, interdependent web of relationships between all of us and our biosphere.

 

I will be speaking at next Integrative Health Care Symposium in Toronto on this topic:

http://www.ihsymposium.com/canada/session/the-future-of-medicine-an-integrative-4p-medicine/

A New Perspective on Aging…

The World Health Organization estimates that by between 2000 and 2050, the world’s population over 60 years of age will double from 11% to 22%.  This amounts to an increase from 605 million to 2 billion persons over the age of 60.

We as a society are woefully ill-prepared for this demographic tsunami.  Part of the problem is our perspective of aging in general  We are really not good are accepting the fact that we are all aging and many of us will have decreasing function and need supports.  It is inevitable, as much as our mortality is inevitable but we humans are good at deceiving ourselves from reality.  We view aging almost as a failure.  We don’t want to see our vulnerabilities in the last part of our lives.  We put are aged away in places where we don’t need to see them.

We need to view aging differently.  We need to view the twilight of life course as part of the bigger story – not just a number of losses towards the end.  This often tends to result in the over-medicalization of these latter years.  Countless visits to doctors, going for testing which can eventually consume a big portion of your day.  But to what meaningful outcome for the patient?  This is where culture comes in.  How do we view our elders, where do they belong in our communities and society.  When we begin to accept the realities of aging and our mortality, we will begin to understand how to live better lives and we will begin to understand how to care for some of the most vulnerable in our society.

Meditation….why it should be part of everyone’s daily routine

We live in an increasingly noisy environment with countless distractions.  There is so much environmental noise, mental noise in our modern lifestyles that stillness, quiet and calm focus is become a rarity.  All this noise creates a low-level chronic stress on our physical and nervous systems.  Chronic stress is a major factor in chronic disease.

What we need more now than ever are tools to help us to be mindful of the present moment, to decrease our stress response and ultimately to be awake and alive to every experience.  The Buddhists have studied the nature of the mind for hundreds of years and calls the distracted mind – “the monkey mind”.  Meditation is one of those tools that can help us still the mind.  It is like a pond which when calm, perfectly reflects back its surroundings (the true nature of reality.  If the pond surface is disturbed, the ripples and fluctuations distort the reflection of the surroundings.

There is increasing evidence that meditation is beneficial for our health.  Research has shown that it reduces blood pressure, chronic pain, headaches, anxiety and depression.  It has also been shown to be effective in boosting immune function, brain function and productivity.  It costs nothing and has no side effects.

Scientific studies have shown clearly that something is happening to brain chemistry when people meditate.  Functional MRI scans on Buddhist monks have shown that meditation produces long-lasting changes in brain biochemistry in areas involved with attention, working memory, learning and conscious perception.

An article published in January JAMA Internal Medicine journal that reviewed 47 trials looking at the effects of medicine concluded that there was insufficient evidence to recommend meditation as a therapy. However the authors did state that they found moderate evidence that mindfulness meditation alleviates pain, anxiety and depression – the latter two to a similar degree as antidepressant therapy. I will say again – meditation costs nothing and has no side effects.  How much scientific evidence to you need for a therapy that has no side effects?  The only side effect of meditation is an increasing sense of connectedness, awareness and presence!

I truly believe that a type of meditative practice where we find time and space to be quiet, to observe our mind, to become more present, to reflect, to feel compassion and gratitude is absolutely essential for health and wellbeing.  Meditation should be a daily routine just like flossing our teeth!  Once you begin to practice, you will begin to feel the benefits.  The true evidence is the direct felt experience that you will have of feeling more alive!

There is a growing body of evidence that is showing the measurable benefits of meditation.

How can we rewire our response to stress?

What is stress?  We all feel it, we can’t escape it, but what is it actually and how does it affect us?

Stress is the physiological response to the perception of a real or imagined threat to your body or self.  The key point here is perception.  An external event is not necessarily inherently stressful – it is how we interpret the signals and how it is processed in our mind and translated into our body.  The threat could be real (biking accident)  but it could be imagined (an assumption that someone was mad at us).  In either case – if we perceive the event as stressful, a cascade of patterned responses ensues.  Adrenaline, cortisol and other stress hormones are released from your brain and permeate every cell in your body. Every cell has receptors for these powerful chemical messengers (hormones).  When you “feel” stressed, your cells feel this stress.  When you feel joy, your cells feel joy so to speak.  The stress response activates the sympathetic response (flight or right) of the autonomic nervous system causing your heart rate, blood pressure to go up, blood more sticky,  increases your blood sugar levels to prepare you for emergency action. This is the right response if there is an acute stressful event that requires you to take action (run away from the sabre tooth tiger).  However, if we are chronically stressed, this adaptive stress response becomes maladaptive and it causes all kinds of problems on the body.  Stress has been identified as a major contributor of many chronic diseases – heart disease, high blood dress, thyroid dysfunction, mood disorders etc.

We are an incredible complex and resilient organism.  It never ceases to amaze me, how much stress, trauma and illness the body can handle, heal and triumph from.  We need to pay attention to what our body is saying to us.  The body communicates to us through symptoms.  What is our body trying to say to us?  It is telling us to slow down, to quit that job that we know we should done long ago but can’t quite make ourselves do it.  The body will say “No’  – if we can’t say “No.  Every symptom or illness should prompt an inquiry and reflection upon what is going on in our lives.

We are learning more and more that our choices we make each and every day contribute to our overall resilience to stress, dysfunction and illness.  Nourishing our bodies with nutrient dense, whole foods provide us with all the co-factors and molecules to ensure our systems are running well and have extra capacity.  Keeping our bodies strong, flexible, supple ensures that energy is flowing freely through our systems and stress is not getting trapped.  Ensuring consistent, restorative sleep is vital.  Learning how to breath – deeply and slowly have profound effects on our stress response.  Do Yoga – it is the best combination of movement, breath and meditation.  Understand our thinking patterns and begin to be aware of how we often make erroneous assumptions about situations and how this causes us stress.  Once we become more conscious and mindful about our perception and responses, we can then begin to re-pattern and re-wire how we respond.

Resilience is about having extra functional capacity so that we can handle increased stress without losing function.  We can all live healthy, happier lives once we begin to understand and shift how we perceive and respond to stress

In Health,

Dr. Lawrence Cheng

Lifestyle Medicine

“It’s time to embrace lifestyle medicine” on the cover of the latest Time Magazine.

We are at a pivotal point in the evolution of medicine where we are beginning to truly appreciate both the incredible power of modern technological medicine but also its limits.  More than 70% of all chronic diseases which account for the majority of the burden of illness in Western countries is preventable by better lifestyle choices.  The US spends about 3 trillion dollars each year on healthcare – 86% of it on chronic disease that can preventable.  There is no end in sight for the rising cost of healthcare and increase demands for disease treatment.  We have barely begun to see the demographic bulge of the “Boomers” enter into their high health care needs.  I work in a busy downtown ER in Vancouver where we are gridlocked everyday.  We routinely treat 25 or more patients in the waiting room everyday that should be in a stretcher space.  There is no more room, there is no more money.  Continuing to treat downstream end organ disease without addressing the prevention side of the equation makes no sense whatsoever.  But in fact, that is what we have been doing.  Governments spend a relatively small percentage of health care money on prevention.  Third party insurers in the US are really beginning to invest in prevention because they realize that if they can prevent a disease, they will save costly payouts for treatments in the future.

Lifestyle medicine is based on epigenetics.  Epigenetics is showing us that the environment that we put ourselves in – what we eat, how we move, how we relate to ourselves and others has more effect in many cases than our disease risk from inheritance.  Genes are not our fate!  The DNA is the hardcode blueprint but the epigenome is the software that makes the whole thing run.  Disease results from the interaction between your genes and your environment.  By changing the environment – you can significantly alter your disease risk.

Dr. Dean Ornish has pioneered some of the key studies that have shown conclusively that lifestyle programs can reverse heart disease.  Lifestyle medicine incorporates proper nutrition, optimal exercise and movement, stress reduction, mind body therapies and understands the importance of healthy relationships with oneself, others and connection with community.  The research is all out there….

Lifestyle medicine should be in many if not most cases, the first line treatment for chronic diseases.  Only after we have optimized lifestyle factors as effectively as possible should we begin to incorporate pharmaceutical drugs or surgery.  Lifestyle interventions is not just for prevention but for treatment of disease.  Many chronic diseases arise from imbalances in our core functional systems.  Most drug therapy does not address these core imbalances, they treat downstream effects and symptoms

It is about time that lifestyle medicine truly is beginning to be seen as effective treatment for disease as well as prevention.  When we address lifestyle factors for real, the side-effect is that the disease fixes itself!

In Health,

Lawrence Cheng MD

A Detoxification Lifestyle…

There is no separation really between us and the environment. There is no separation between the quality of the air we breathe and the oxygen that flows through our lungs and into every cell of our body. There is no separation between the health of our water supply in our oceans and rivers and the health of our blood and fluids that course through our arteries and veins. There is no separation between the food we eat and health of the soil, plants and animals that we share this planet with. David Suzuki talks about this “Sacred Balance”. We cannot talk about human health separate from the health of the planet.

We are living in an increasingly toxic environment. Chemicals are everywhere: In our homes, in our workplaces, in products we put on our body and to the food-like substances that we eat.   It is estimated that there have been over 80,000 new chemicals introduced into the environment since World War II. There is a growing body of scientific evidence that links the exposure and accumulation of toxins with human disease. Many common conditions have been associated with toxicity: obesity, diabetes, thyroid disorders, asthma, chronic fatigue, autoimmune conditions and cancer to name a few.  In fact allergies, autoimmune conditions and cancer continue to become more prevalent despite improving living conditions and medical advances. Our genome (our DNA) has not had time to adapt to these new chemicals, as a result damage occurs and disease manifests.

Low dose exposure is not necessarily safe exposure. We really don’t know the long-term effects of most of the chemicals or drugs that we have produced. No evidence for harmful effects is not the same as “evidence of NO harm”. The only rational approach to this is to follow the precautionary principle which states that we have the duty to prevent harm when it is within our power (and institutions) to do so – even when the evidence is not in.

Furthermore, we are learning that one’s ability to detoxify (break down chemicals and render them harmless and eliminate them safely in our body) can be quite variable due to the individual’s genetic and biochemical uniqueness. What might be a ‘safe’ exposure for 90% of the population could cause significant disease in an individual who has impaired ability to detoxify certain compounds. Reducing exposure is the best advice and appreciating individual susceptibility.

One’s ability to detoxify substances to which he or she is exposed to is critical to overall health and prevention of disease.   How well our body detoxifies can be modified by our lifestyle.

The elements of a detoxification lifestyle is:

  1. Avoid exposure to all known sources of toxicity as much as possible.
  2. Optimize your nutrition by consuming a diet that is high in phytochemicals (beneficial compounds found in fruits and vegetables. Onions and garlic, cruciferous vegetables, citrus, green tea etc. all act in a complex, beneficial manner to improve our detoxification systems.
  3. Regular moderate intensity exercise most days of the week helps increase antioxidant enzymes in your body, improves lymph drainage and increased elimination through sweating.
  4. Restorative sleep, rest, relaxation and rejuvenating play are essential elements as well.
  5. Finally, true detoxification includes eliminating toxic influences of all kinds that do not serve us – not just chemicals. This includes toxic self-limited beliefs about our selves, maladaptive patterns of behaviours, toxic relationships etc.

We have an incredible ability to withstand stresses from all kinds of toxins from environmental to emotional. This is the wisdom and intelligence of the body manifest but we need to give our bodies the best chance to do this by living a lifestyle that helps are body, mind and spirit be strong. How we live each and everyday makes all the difference.

In health,

Dr. A. Lawrence Cheng MD CCFP(EM), MPH

Why we need functional medicine?

Why we need functional medicine?

“Problems cannot be solved by the same level of thinking that created them”.

Einstein

The most powerful question one can ask is “Why?” In medicine this translates to why did this particular person get this form illness at this particular point in time? This is the question we need to ask more in modern medicine.

We are facing an epidemic of chronic disease around the world. Over 70% of the disease burden now comes from chronic disease not infections or trauma. Despite all the money being spent on drugs, procedures and surgery, the incidence of chronic disease continues to rise.

We need more than ever a new paradigm in medicine that focuses on prevention and looks closely at the root causes of illness rather than just treating the end manifestations of end-organ disease.

We need a new medicine that looks at the person as an integrated whole – mind, body and spirit; appreciates our biochemical individuality; understands that most chronic disease arises from imbalances that result from a mismatch between our genes and the environment (Lifestyle).

We need a model that reflects the new science emerging from the genomic revolution – in particular epigenetics. What we are learning from epigenetics is that our genes are not our destiny – it is not a fixed blueprint. What actually manifests as structural components of your body and the biochemical machinery that runs everything depends largely on what genes get translated (what gets turned on or off). How your genes get translated is a result of interactions with the environment. This means – how you live each and every day (the food you eat, the way you move, breath, interact with the world) determines how your genes gets expressed. Your phenotype (the actual expressed genome) can be quite different than your genotype (DNA code).   This is an incredibly complex and brilliant system that allows the organism to adapt continuously to a changing environment.

We need to realize that the naming and classification system of diseases helps us match signs and symptoms to a diagnosis and then to a corresponding treatment but it doesn’t mean that we understand the root cause of the problem. In fact – we don’t know the root causes of many chronic diseases.

For acute illness caused by an acute infection or injury – the root cause is fairly clear. But the root causes of a disease that takes many years to develop –sometimes decades (long latency), result in myriad of symptoms in different organ systems is much more difficult to ascertain. Our current tools in our medicine toolbox are great for acute trauma and illness but not so good for long latency complex chronic disease.

The principles of functional medicine are as follows:

  1. Functional medicine uses a systems based approach that looks for root causes of illness and imbalances in core physiological processes rather than focus on treating symptoms.
  2. Functional medicine works “upstream” rather than “downstream” by looking for patterns of dysfunction before they manifest into disease if possible.
  3. Looks at the person as an integrated whole – mind, body and spirit.
  4. Recognizes that everyone is biochemically and physiologically unique. There is no one size fits all treatment. Treatment is personalized.
  5. Recognizes that chronic disease arises from the interactions between our genome and environment. Uses lifestyle as prevention and treatment by focusing very carefully on nutrition, exercise, sleep, stress reduction and our relationship with ourselves, others and the world.
  6. Integrating best practices from conventional biomedicine with other modalities like natural medicines, (Naturopathy), Traditional Chinese Medicine, Massage, Chiropractic, mind/body therapies (yoga, meditation) etc.

What we need is a new paradigm that understands that there we are inter -connected to everything – on both a physical and energetic level. Our cells are part of tissues, which are part of organs, which are part of organ systems, which work together to form our whole person, the person is part of a community, which is part of an ecosystem, which part of the biosphere. A holistic, deeply conscious systems based approach is really the only ways forward if you understand this.

It is my sincere hope that we continue moving in this direction. This is why Connect Health Centre for Integrative + Functional Medicine was created.

Happy New Year!

Wishing everyone radiant health!

Dr. Lawrence Cheng MD, CCFP (EM), MPH

Co-founder and Director

Connect Health Centre for Integrative + Functional Medicine