Western Science, Asian Medicine
Here are links to recent articles and reports about the nature of human health and it deep connections with diverse environmental influences including the physical, the social, and the spiritual dimensions of our lives.
Because of my long-term interest in the quantitative aspects of Western sciences and my Asian Indian heritage, you will find information here covering a broad range of issues related to healing and medicine. Both Asian ideas about health and current Western scientific and medical research.
On Lifestyle, Obesity, Diet, Exercise, Sleep
I hope that readers of Chinese medicine— TCM, Zang-Fu theory, 5 Phase/Element model of health and disease, etc., will find these articles on the effects of lifestyle (e.g., diet, exercise, sleep) on health and the inter-conversions between carbohydrates and fats useful in developing their own insights into linkages between the functions of Wood (Liver), Fire (Heart), and Earth (“Stomach-Spleen”, the absorption-assimilation and transporting functions of the G.I. system).
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happy readings…
PK
P.S. Your comments and thoughts are appreciated. Send an e-mail, to tell me what you think.
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FALL 2013
Fiber is a forgotten nutrient in our considerations of an optimal diet. Though adult diets are expected to contain at least 30 grams of total fiber (i.e., soluble + insoluble) per day, the average American diet contains between 10-15 grams per day. Some are even lower.
Perhaps this is because fiber has no champion in the healthcare community, except for those promoting products to people who are trying to avoid constipation. Cooked foods such as cereals and grains, vegetables, and fruits generally contain between 3 -10% fiber. Beans and dried spices are the highest contributors to our dietary intakes.
For a listing of the fiber content of selected foods, based on data provided by the Food and Nutrition Information Center (USDA), click here.
As the review article below notes, individuals with high intakes of dietary fiber appear to be at significantly lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases.
Increasing fiber intake also lowers blood pressure and serum cholesterol levels. In addition, increased intake of soluble fiber improves glycemia and insulin sensitivity in non-diabetic and diabetic individuals.
To add to these benefits, fiber supplementation in obese individuals significantly enhances weight loss. Increased fiber intake appears to benefit a number of gastrointestinal disorders including gastroesophageal reflux disease (GERD), duodenal ulcer, diverticulitis, constipation, and hemorrhoids.
Prebiotic fibers appear to enhance immune function. Dietary fiber intake also provides similar benefits for children.
Health benefits of dietary fiber
James W Anderson, Pat Baird, Richard H Davis Jr, Stefanie Ferreri, Mary Knudtson, Ashraf Koraym, Valerie Waters, and Christine L Williams
Nutrition Review, 2009 Apr;67(4):188-205. doi: 10.1111/j.1753-4887.2009.00189.x.
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SPRING 2013
As the authors of this review article point out, the human gastrointestinal microbiome is an ecological community that influences normal physiology and susceptibility to disease and is of special relevance to chronic inflammatory patterns, through both its collective metabolic activities and host interactions.
Viewing the microbiota from an ecological perspective provides insights into how to promote health by targeting this microbial community in the clinic. In addition, understanding the factors that underlie changes in composition and function of the gut microbiota will aid in the design of new therapies.
Till Big Pharma begins to market next generation nutraceuticals based on current research on prebiotics and probiotics, a few low-cost ideas will help improve public health—
- Eating a diversified variety of complex carbohydrates, fermented foods (e.g., kefir, kimchi, sauerkraut, miso, etc.) and less processed foods will help.
- Reducing the use of antimicrobial products and antibiotics as a “cleansing” strategy will also benefit our health.
- Meats are often a large source of antibiotics in Western diets.
Diversity, stability and resilience of the human gut microbiota
Catherine A. Lozupone, Jesse I. Stombaugh, Jeffrey I. Gordon, Janet K. Jansson & Rob Knight
NATURE, VOL 489, pp220-230, 13 SEPTEMBER 2012
REVIEW doi:10.1038/nature11550
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Why eating more meat is not such a good idea
The adverse environmental impacts, i.e., increased greenhouse gases, associated with raising, and consuming large quantities of animal proteins (e.g., beef, pork, chicken), is well established. More recently, there is an emerging consensus that eating large quantities of meat (e.g., more than 4-6 oz or 120-200 g per day) has adverse impacts with respect to cardio health. However, the precise nature of these impacts has been unclear.
Here is a recent article suggesting that gut flora and action by the liver can transform certain amino acids (e.g., carnitine) and lipids (i.e., lecithins) containing the trimethylamine fragment into a molecule ( TMAO, trimethylamine oxide) that causes damage to the lining of blood vessels.
Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis
Robert A Koeth, Zeneng Wang, Bruce S Levison, Jennifer A Buffa, Elin Org, Brendan T Sheehy, Earl B Britt, Xiaoming Fu, Yuping Wu, Lin Li, Jonathan D Smith, Joseph A DiDonato, Jun Chen, Hongzhe Li, Gary D Wu, James D Lewis, Manya Warrier, J Mark Brown, Ronald M Krauss, W H Wilson Tang, Frederic D Bushman, Aldons J Lusis & Stanley L Hazen
Nature Medicine (2013) doi:10.1038/nm.3145
The second article is from 2011 and also shows how gut flora promote diet-induced atherosclerosis. More specifically, a novel pathway linking dietary lipid– i.e., phosphatidylcholine (lecithin) or choline intake, conversion of the choline fragment by intestinal microflora into trimethylamine, and its subsequent conversion to trimethylamineoxide (TMAO) in the liver, leading to endothelial damage and atherosclerosis.
Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease
Zeneng Wang, Elizabeth Klipfell, Brian J. Bennett, Robert Koeth, Bruce S. Levison, Brandon DuGar, Ariel E. Feldstein, Earl B. Britt, Xiaoming Fu, Yoon-Mi Chung, Yuping Wu, Phil Schauer, Jonathan D. Smith, Hooman Allayee, W. H. Wilson Tang, Joseph A. DiDonato, Aldons J. Lusis & Stanley L. Hazen
NATURE, VOL 472, pp57-65. doi:10.1038/nature09922
Eating less meat seems to be better, both for human health and for the Earth.
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FALL 2012
Here is a very interesting article that looks at the roots of Chinese medicine. More specifically, at the deep connections between the spiritual and the physical dimensions of human health.
This formal recognition of the interconnections between the individual and their environment is a common aspect of many traditional systems of medicine, including the Indian system of medicine known as Ayurveda. As the authors note–
The basic theory of Chinese medicine reflects an overall constantly dynamic and dialectical way of thinking. In the whole universe, all things mutually reinforce and neutralize each other, which is a kind of continuous process. The same source of all the creatures is Qi, which is divided into two natures as Yin and Yang to achieve balance in the interaction process. The promotion and generation of all the creatures will become the five elements, and the promotion and restriction of the five elements have the nature of yin and yang, so all creatures are composed of the five elements. A human body, divided into the five elements and born from the five elements, can be seen as one part of all the creatures in the universe.
Spirituality in Traditional Chinese Medicine
Lin Shi and Chenguang Zhang
Pastoral Psychology, 2012, Volume 61, Numbers 5-6, Pages 959-974
DOI 10.1007/s11089-012-0480-x
The free article can be found here.
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SPRING 2012
Here is an interesting paper that proposes a link between chronic stress, blunted response to the normally protective effects of cortisol, and the tendency to catch common colds or other diseases. More specifically, that exposure to chronic stress can result in resistance to the actions of cortisol, an adrenal hormone (i.e., glucocorticoid resistance or GCR), which, in turn, interferes with the endocrine (i.e., hypothalamc-pituitary-adrenal or HPA) down-regulation of local proinflammatory cytokine response to infectious agents. In this study, a rhinovirus— the virus associated with common colds was the infectious agent. They also claim that without appropriate cortisol regulation of the local cytokine response, which appears to be tissue specific, there would be an increased expression of the signs of an upper respiratory tract infection.
In Chinese medicine , we speak of the sensitivity of the Lung (“the tender organ”) to pathogenic influences and of these dysfunctional organ network interactions as aspects of Wood<>Metal disharmony. From the Western perspective, the nascent concept of psychoneuroimmunoendocrinology describes the interrelationships of mental, neurological, hormonal, and immunological functions, addressing the impact of cognitive processes on the central nervous, endocrine, and immune systems. Societal factors can affect health adversely.
Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk
Sheldon Cohen, Denise Janicki-Deverts, William J. Doyle, Gregory E. Miller, Ellen Frank, Bruce S. Rabin, and Ronald B. Turner
PNAS 2012; vol. 109, no. 16, pp5995–5999.
http://www.pnas.org/content/109/16/5995.full
SUMMER 2011
The title of this recent article from the Proceedings of the National Academy of Sciences (PNAS, U.S.) says it all – we need to exercise more regularly. To reduce both the impact of metabolic syndrome and its potential health effects, with regard to morbidity, on ~50% of the U.S. population and the “downstream” economic impacts of increased healthcare costs associated with managing a broad range of organ level disorders which emerge as sequelae to this syndrome.
To be more specific, this study suggests that even a single round of exercise can affect the response of skeletal muscle to insulin and lead to the lowering of blood sugar in diabetic individuals.
Reversal of muscle insulin resistance with exercise reduces postprandial hepatic de novo lipogenesis in insulin resistant individuals
Rasmus Rabøla, Kitt Falk Petersena, Sylvie Dufourb, Clare Flannerya, and Gerald I. Shulman
PNAS 2011; vol. 108 , no. 33, pp13705–13709.
http://www.pnas.org/content/108/33/13705.full.pdf
excerpted from the article above—
“metabolic syndrome is characterized by a clustering of risk factors for cardiovascular disease that include abdominal obesity, atherogenic dyslipidemia, hypertension, hyperuricemia, a prothrombotic state, a proinflammatory state, nonalcoholic fatty liver disease (NAFLD), and insulin resistance. The metabolic syndrome is estimated to afflict 50 million Americans, and approximately half of all Americans are predisposed to it. Individuals with the metabolic syndrome are at increased risk for the development of coronary heart disease and other diseases related to plaque buildup in artery walls, such as stroke and peripheral vascular disease, as well as type 2 diabetes.”
Prescribing Lifestyle Medicine
Liana S. Lianov
Posted: 08/15/2011
http://www.medscape.com/viewarticle/747665
Here is an article from Medscape on the challenges facing conventional Western medicine practitioners who are beginning to acknowledge that lifestyle choices may have better outcomes and a greater influence on promoting wellness than prescribing pharmaceuticals for managing disease like diabetes.
For those of us in Traditional Chinese Medicine (TCM) who promote a system level approach to health and wellness, this is welcome news. The physician-healers of our tradition who have claimed for thousands of years that doctors at the highest level utilize food and nutrition as the first level of therapeutics in the practice of internal medicine (i.e., Chinese herbs) must be smiling.
Hippocrates, the founder of the Greek (and contemporary Western) healing traditions from over 2000 years ago, held a similar position with regard to the relationship between food and medicine.
excerpted from the article above, citing the recommendations of a 2009 panel of American College of Preventive Medicine (ACPM) and the American College of Lifestyle Medicine (ACLM) physicians-
“Lifestyle medicine is the evidence-based practice of helping individuals and families adopt and sustain healthy behaviors that affect health and quality of life. Examples of target patient behaviors include but are not limited to eliminating tobacco use, improving diet, increasing physical activity, and moderating alcohol consumption.”
SUMMER 2010
About Obesity & Special Diets
There is a lot of information out on the web about the benefits of low carbohydrate (carb) diets. What nobody explains is that these low carb diets also cause people to eat less food (i.e., total calories). This apparently is the real reason for people losing weight.
The exact reasons for the satiety induced by high protein and fat diets is not clear. The two articles below discuss this in greater detail. Both are accessible for free.
Low-carbohydrate nutrition and metabolism
Am J Clin Nutr 2007;86:276–84
http://www.ajcn.org/cgi/reprint/86/2/276
Eric C Westman, Richard D Feinman, John C Mavropoulos, Mary C Vernon, Jeff S Volek, James A Wortman, William S Yancy, and Stephen D Phinney
ABSTRACT
The persistence of an epidemic of obesity and type 2 diabetes suggests that new nutritional strategies are needed if the epidemic is to be overcome. A promising nutritional approach suggested by this thematic review is carbohydrate restriction. Recent studies show that, under conditions of carbohydrate restriction, fuel sources shift from glucose and fatty acids to fatty acids and ketones, and that ad libitum–fed carbohydrate-restricted diets lead to appetite reduction(emphasis added) weight loss, and improvement in surrogate markers of cardiovascular disease.
Editorial: Is There Something Special about Low-Carbohydrate Diets?
Ann Intern Med. 2005;142:469-470. www.annals.org
George A. Bray
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