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wine-glasses

Alcohol and Your Health – Cheers! or Not?

Depending with whom you speak, alcohol can be a villain or it can be a hero. We have long known that alcohol can help reduce the stress of everyday life, and even relaxes our most tightly wound friends and associates. Recent data also suggests that fairly regular alcohol ingestion is actually good for your heart. This is probably one of the reasons that many European countries, where wine is a normal part of everyday life, have significantly lower rates of heart disease despite relatively high fat diets. The protective effects may come from substances called flavonoids and also antioxidants that are found in alcohol, especially wine. It also can increase HDL levels (the good cholesterol) and lower the risk of blood clots by slightly “thinning” your blood (anti-platelet effect). Red wine also has resveratrol, a compound that has been shown to possibly reduce lung damage in patients with chronic bronchitis and emphysema, by lowering levels of interleukin 8, a chemical that causes lung inflammation. It has also been touted to have life extension (i.e. longevity) and disease fighting capabilities but more research is needed.

Too bad it’s not that easy, i.e. “drink to your heart’s content.” There is a dark side. Even the American Heart Association cautions people NOT to start drinking if they do not already drink alcohol. For many, alcohol can be deadly. It can be a cellular toxin, with brain cells and liver cells particularly susceptible. Alcoholism is a serious disease, with some predisposed from a genetic standpoint. For them, there is no safe amount. It is also never safe or recommended during pregnancy because of the harm it can cause to the developing baby. Alcohol can be dangerous for those with certain medical conditions such as diabetes and liver ailments and also has been implicated in the development of certain cancers. Also many alcoholic beverages pack a significant amount of calories which contribute to obesity risk and much of the obesity epidemic.

Alcohol also kills when mixed with driving. I believe we will see tighter restrictions regarding the legality of drinking and driving especially in terms of acceptable blood-alcohol content. Recent scientific data suggests that we actually loose coordination as well as other important motor and cognitive skills essential for safe driving, even while we are within the legal limits of blood alcohol levels. The National Highway Traffic Safety Administration, in conjunction with The University of Iowa, is doing research on driving under the influence using a three ton, $81 million DUI simulator. This simulator puts the drunk driver in “real life” road situations using high resolution 3-D images, and monitors reaction times and other motorist behaviors. Hopefully studies like this will help provide safer guidelines for us. I am fairly certain that study will have no trouble finding volunteers. There are even commercially available simulators (drunk driving and texting while driving) for educational purposes.

Being an orthopedic surgeon, who has spent plenty of time in the ER, I can state without hesitation that impaired driving kills, and kills many, dramatically changing lives (even innocent ones), be it alcohol, marijuana, or other drugs. Ditto for cell phone distracted driving. All preventable.

So, what is the right answer for you in terms of alcohol? The key, like so many other things in life, is balance and moderation. Weighing risks with rewards and being responsible, not only to yourself, but to those around you.

Poison or potion? It is up to you. Remember, moderation is the key. Check with your doctor to see if there is a place for alcohol in your path to better health.

Originally published on the Huffington Post. Reprinted with permission from Dr. DiNubile.


Nicholas DiNubile, MD is an Orthopedic Surgeon, Sports Medicine Doc, Team Physician & Best Selling Author. He is dedicated to keeping you healthy in body, mind & spirit. Follow him MD on Twitter: twitter.com/drnickUSA

DNA-puzzle

The Evolution of Truly Personalized Medicine: Epigenetics, Food, and Fitness

Most would not argue that there is ongoing transition in how our healthcare is being delivered. This article will examine some of these transitions as a result of breakthroughs in technology, as well as how genetic information, exercise, and diet will play an increasingly greater role.

When medical science was first getting its start, a more holistic philosophy was taken on how to treat illness and maintain health. Hippocrates is often deemed the father of modern medicine, and even today the allopathic physicians (M.D.s) take the Hippocratic Oath – to do no harm to their patients. Hippocrates knew, even in 400 B.C., that the best healer of the body is the body itself. For the most part, the best treatment is to create a strong body and get out of the way. Five guiding principles used in his philosophy for treatment include:

  1. Walking is man’s best medicine.
  2. Know what person the disease has, rather than what disease the person has.
  3. Let food be thy medicine.
  4. Everything in moderation.
  5. To do nothing is also a good remedy.

The second and fifth principles emphasize the power of knowing the individual and getting out of the way! The first and third principles show the power of exercise and food for healthy living. Even the genius, Thomas Edison, realized that a health maintenance organization (HMO) approach was the best method of healthcare both practically and financially. His quote, “The doctor of the future will give no medicine but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease,” is evidence that a holistic, preventative approach is what he advocated. He is also quoted, “…you can’t improve on nature.”

One size does not fit all

Personalized medicine is now on the forefront and it utilizes the genetic and epigenetic data of a person to guide medicines and treatment plans. Cancer drugs have probably harnessed this advantage to the greatest extent, thus far. Former President Jimmy Carter received Keytruda (pembrolizumab) for his brain cancer and it boosted his immune system and beat the cancer. While most of America (71%), still doesn’t even know about personalized medicine, those who were familiar with it did not know it would yield better results with fewer side effects. The different directions of personalized medicine are still being realized, but the field of pharmacogenetics is the first to really jump on the bandwagon of highly effective, precision-based treatment.

The reasons some drugs work for some people and not for others, or why side effects occur in some individuals and not others, is due to individual variability in metabolism. Why are some people lactose tolerant, or some can drink alcohol with no problem, and others have severe issues? It is usually because of enzyme differences, which are under the control of our genes. Interestingly, our enzyme genes can often be turned on or off by “inducible sequences” known as promoters or suppressors of operons, respectively. These “switches” can be repressed or induced depending on our environmental stimuli. Thus, we actually have some control over our gene expression, and this field is known as epigenetics.

Knowing what gene variants someone possess or not will guide the personalized medicine physician on which drug to use or not. By knowing allergic reactions in advance or which medicines may have side effects will help physicians to not make a bad situation worse. Unfortunately, the cost of personalized medicine drugs is much higher than alternative treatments. There is still a lot of exploration to be done on all the various applications of this technology, but the bottom line is that understanding individual variations and enabling the body to do what it is designed to do is a very good thing! Companies like Toolbox Genomics is one of many companies that use your genetic information to then tell you what foods and supplements to eat or avoid, and which exercises may help you the most, and ones that you may not respond to so well. The reason physicians do an intake on family history, or run various tests is to collect information that will guide their treatment. A genetic test on certain gene variants is simply taking this a step further.

How does exercise and diet apply to our epigenetics?

Did you know that exercise is highly beneficial to not only help with fighting cancer once it is already present, but also to never getting it? Physical exercise or movement in general will shift the epigenetics so that genes that suppress tumors are increased, and genes that cause cancer (oncogenes) are decreased. It does this by changing the amount of certain reactions called methylations. Things go wrong when there is too much or too few methylation reactions. Exercise has been shown to reduce or even reverse the epigenetic mutations that often result in tumorigenesis or tumor production. Exercise has also been shown to reduce genetic factors associated with aging like telomere length.

The fields of proteomics and metabolomics as well as pharmacogenomics, are all emerging because of the knowledge on how our genetics affects proteins, metabolism, and reactions to drugs, respectively. The field of nutrigenomics is rapidly expanding, and several companies are capitalizing on studying the relationship of how our genes affect how we process and utilize foods, as well as how food can affect our genes. Vitamins A and D, certain fatty acids, especially medium and short chain, some sterols (derived from cholesterol) and zinc have been shown to directly influence gene transcription. In direct effects include how diet affects gut bacteria, which in turn influences gene expression. Soon when nutritional recommendations are given, it will likely be “for this individual.”

The future of medicine will be taking our genetic information to a whole new level. Soon “smart” watches, clothes, hats, and other common devices will collect information that can benefit our health in many ways as the way healthcare is delivered continually evolves.

This article was featured in MedFit Professional Magazine summer 2019 issue.

Subscribe to MedFit Professional Magazine to read more great content like this!


Dr. Mark P. Kelly has been involved with the health and fitness field for more than 30 years. He has been a research scientist for universities and many infomercial projects. He has spoken nationally and internationally on a wide variety of topics and currently speaks on the use of exercise for clinical purposes and exercise’s impact on the brain. Mark is a teacher in colleges and universities in Orange County, CA., where Principle-Centered Health- Corporate Wellness & Safety operates.

kettlebell-sneakers

The Three R’s: Reset. Reload. Reinforce.

Before you can begin checking the boxes off above a baseline needs to be established. What is the best way to set a baseline that isn’t time-consuming? A Physical Therapist can test physical capacity, but will that give them the total picture? What if you are a health care provider such as a Massage Practitioner or a Chiropractor, or a doctor of an individual who wants to start an exercise program? How do you set-up a baseline of indicators to capture dysfunction at the level of the movement pattern, not just muscles/tissues that are weak or injured?

The quickest and easiest way I know of is a Functional Movement Screening and a Movement Assessment Screening. It is a ranking and grading system to measure asymmetries. If there is a pain in any of the movement patterns the activity is stopped and a referral is made. As a Functional Movement Specialist, I can do the movement screening with a printed report and corrective strategy exercises to reinforce quality movement patterns. This establishes a baseline to work from and retesting is done periodically.

The way this effective approach works: Each box needs to be checked off before you move to the next box.

The meaning of the three Rs is…

Reset

When a patient/client goes into a Physical Therapist for treatment, or Massage Practitioner for manual manipulation of muscles/tissues, or Chiropractor for a muscular skeletal adjustment. After the procedure the next step is usually, rest, ice, maybe some stretches and to review or start an exercise program. Ok, if this is the standard procedure followed, what is missing from this picture?

Reinforce

This next step is where I as a Fitness Trainer am highly effective, first with myself and now others. I took my twisted muscular-skeletal frame from a seat belt injury and started retraining the correct movement patterns by reinforcement. It takes about 7,000 repetitions of a movement pattern before it becomes spontaneous. What do I mean by reinforce? Reinforce means you either go back to what you were doing with the same faulty movement pattern and setting yourself up for needing another reset, instead of going in for a maintenance appointment. Keeping the cycle of dysfunction and asymmetries going that lead to dysfunction, pain and injury.

Reload

A combination of corrective exercises and conditioning work, such as using supersets to establish better hip hinging and then doing deadlifts, and then maybe add some kettlebell swings.

Reload the frame with the right resistance that maintains the right movement pattern exercises. I use a wide variety of tools based on the client’s needs and preferences.

Reset, reinforce and reload can be applied to both rehabilitation and exercise. In rehabilitation, Physical Therapist/Health Care Provider is working with pain and dysfunction. Exercise professionals work with dysfunction by setting up a baseline and reinforce correctives and conditioning to help prepare the individuals to return to a full active life.

I have successfully retrained my body after a seat belt injury that caused asymmetry imbalances, and now successfully use these remedial corrective strategies with my clients. I give my clients enough practice to learn how to move efficiently, and believe in open communication, taking after hour calls and making home visits.

Move well, move often, stay fit, live!


The Kettlebell Lady – Leanne Wylet, BA, ACE -NCCA, specializes in Orthopedic Exercise, Functional Movement, Hard Style/High Intensity Kettlebell Fitness, Silver Sneakers FLEX & Tai Chi Instructor works with the aging population. She has come back from a seat built injury that left her disabled and two major illnesses; her body is now restored. Taking the skills she’s developed, plus academic training, she works with individuals in all walks of life from youth to those in their golden years. Visit her website, kettlebelllady.com

Walk Park

Natural Prescription – An Alternative Approach

One of the best things we can do for our bodies is to “get out of the way”! Believe it or not, our body can actually do a great job of healing itself, or functioning quite optimally when it’s allowed to do so. The body does this by reacting to what “stresses” are put upon it and finding homeostasis through temporary changes or more permanent adaptations. Even the brain will make quick reactions to things in the form of neurotransmitters and neural firing or long term adaptations in adopting new ways of perceiving things or hard-wiring changes.

A statement capturing the above sentiment is from Goodheart (1989) on healing, “People are healed by many different kinds of healers and systems because the real healer is within. The various healing modalities are merely different ways of activating the inner healer.” 1

Are you of the Mechanist (Rationalist) or Vitalist (Empirical) Approach?

The standard or “orthodox” medical practice in the U.S. follows a mechanist approach, where symptoms are perceived as bad and should be minimized or suppressed through surgical or pharmaceutical means. This seems great at the surface level. If something is causing me pain or discomfort let me do something to relieve or eliminate that pain. If I am having nausea or diarrhea because of something in my gut, let me take something to stop the vomiting or diarrhea. Underlying this “quick fix” of symptom alleviation is THE PROBLEM.  The body is trying to rid itself of the “problem” by expelling if forwards or backwards!  There are many medical conditions for which it is okay to consider treating symptoms, and for some this is vital.  However, it is preferable for this to be done in conjunction with identifying the source of the problem, so a long-term fix can be explored.

ChirocopractorA Vitalist approach views symptoms as part of the healing process, not a problem that should be hidden. Many branches of health care use this philosophy including: chiropractors, osteopaths, naturopaths, and practitioners of Chinese or Indian medicine advocate this Vitalist approach. By suppressing the symptoms, the practitioner may actually be extending the illness or exacerbating the problem. Researchers at the University of Maryland found taking aspirin for the flu may prolong the illness up to 3 days. Acetaminophen (Tylenol) or aspirin interferes with the normal fever response that fights the infection (Burke, 2000).

Listening to the Symptoms tell you Where the Problem Lies

Rather than reducing or eliminating the symptoms, what if we tried to increase our sensitivity to it. For example, if we took antibiotics to fight a bacteria, are we enhancing the body’s immune response to this foreign agent or “giving it” something to help, much like a crutch. A quote from unknown origin:

Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.

This is at the heart of the Vitalist approach. The body is great at adaptation but we have to let it “learn” to adapt- not “feed” it some drug that forces it to do something. A quote from the Nobel Prize winner, Rene Dubos, Ph.D. remarks, “Good health is a process of continuous adaptation to the myriad of microbes, irritants, pressures and problems which daily challenge man.” This is also at the heart of exercise training. You must “overload” a system in order to get an improvement in function. You literally must stress it, and let it endure that strain in order to get the adaptation. Likewise, by putting your body in destabilized environments, you will gain a better sense of balance, in order to stabilize yourself.  Recent evidence has found that anti-inflammatory agents actually weaken the endurance training effect.

Fortunately, medical advances have allowed us to treat many illnesses effectively and safely, and it is always advisable to follow the advice of your doctor.  Allowing your body to adapt to certain stresses can be very positive in certain scenarios, but it is important to recognize when this doesn’t come at a risk of increasing morbidity, mortality, or increasing the likelihood of illness complications.

To Drug or Not to Drug: that is the Question

Prescription drugsNo one likes being depressed. About one in 10 Americans takes some sort of antidepressant medication. It is the most commonly prescribed drug in the U.S. according to a report published in the Archives of General Psychiatry (2009).  While the U.S. may not be a Prozac Nation, as popularized in 1994 by the author Elizabeth Wurtzel, the rates almost doubled from 1996 to 2005 (5.84% to 10.12%). A report in the Journal of the American Medical Association found it to work best in only severe cases of depression and exercise had similar effects in the short term treatment and better effects in long term treatment! The difficulty lies in getting someone to exercise when they are depressed. Thus, an integrated approach is often the best, and this includes psychological counseling as well.

Sometimes Less is More

A take away from this article should not be that standard medical care is bad. Far from it. Many M.D.s are very knowledgeable in areas outside of their standard practice and advocate expressive, rather than suppressive therapies. The take away should be to not rush for a drug to hide or mask your symptoms, but focus on what is the root of the cause, and take action to address this. The term iatrogenic is used for the inadvertent problem caused by a medical treatment. In fact, reports estimate it to be the third leading cause of death in the U.S. with 225,000 to 250,000 dying from iatrogenic diseases annually! While it is hard to say how many of these deaths could have been avoided, it is quite obvious that minimizing invasive treatments until they are necessary is the best plan of action.

Complementary or Integrated medicine can possibly have the answer to a majority of the health issues presented. The Medical Fitness Network believes those professionals are the future of health care.


Dr. Mark Kelly Ph.D., CSCS, FAS, CPT has been actively involved in the fitness industry spanning 30 years as a teacher of exercise physiology at academic institutions such as California State University, Fullerton, Louisiana State University, Health Science Center, Tulane University and Biola. He was an exercise physiologist for the American Council on Exercise, a corporate wellness director, boot camp company owner and master fitness trainer.