A Better Medical Paradigm for ” Underlying Health Conditions”
Why We Need Functional Medicine Now
“Underlying health conditions” are key factors in many of those afflicted with COVID-19. The disease, COVID 19, appears to be affecting a population, to a much greater degree, with underlying chronic health issues, such as diabetes, heart, lung and kidney disease, obesity, high blood pressure and more. These are conditions that are traditionally controlled and treated with medications or surgery with minimal education in nutrition and lifestyle. In fact, poor diet now outranks smoking as the leading cause of death globally and in the U.S., yet, medical students are poorly trained in nutrition as a viable and effective treatment and disease prevention option. (1,2) But how are our immune systems faring in light of the present situation? If we continue to use the same medical model and don’t address chronic conditions in a more holistic way, are we creating a physiology that is more vulnerable to infection and disease?
We are singularly focused on a disease outcome, when perhaps we should also be looking at why we are so vulnerable in the first place. According to the Milken Institute report in 2018, the direct health care costs in the U.S. for chronic health conditions were $1.1 trillion in 2016. Today, 60% of Americans have one chronic disease and 40% have two or more chronic diseases. By 2030 it is projected that Americans will have three or more chronic diseases. Spending on prescription drugs is projected to increase more rapidly than health care spending overall. (5) The statistics and costs for chronic disease are staggering and growing. We are becoming sicker, less resilient and ill prepared to face a novel virus like the corona virus or any other future threat.
A healthcare system that provides quick fixes with medication does not help us build up the type of resilience we need in the current climate. With symptomatic treatment, we may be playing “whack a mole”, trying to suppress what is being expressed instead of understanding why there are symptoms of dysfunction in the first place. Without addressing core issues, we may be creating an internal environment that is making us more susceptible to illness. Medical doctors are trained in the pharmaco-centric medical paradigm, matching symptom to medication. The model of the disease is tailored to the drug paradigm rather than being patient centered. There is no assessment to determine how adequately (or not) we are supported by our nutrition, lifestyle and environment. For acute conditions and infections, conventional medicine IS life saving, however, for the chronic issues, is this really the right approach? Conventional medicine continues to look for a treatment within the same model of care (pharmaceuticals, vaccines, etc.) when perhaps it’s time to look for a new model.
As a society, there is also the expectation that we should instantly feel better if we just “take this for that”. We want the fast and easy treatment so that we can continue our current lifestyle, despite the fact that the lifestyle may be the exact cause of the illness, read: too much caffeine, stress, and fast food, too little sleep or exercise. The only work required of us is to remember to take a pill. If we have high blood pressure, we take something to lower it, heartburn requires heartburn medication, pain requires pain medication and the list goes on. We are also conditioned to believe that symptoms happen just because we are women or men. We are being told, “you are just getting older” or “this is just in your genes”. This perpetuates the belief that we have no control over our health. We must rely on the pill or the surgery and symptoms are inevitable given our sex, age or genetic makeup. It’s time to stop accepting that there is nothing we can do except live with a chronic condition. The questions we need to start asking are why did it show up in the first place and how do I start addressing the roots in a holistic way?
If we are going to have a chance in combatting COVID-19 or any future illness for that matter, we need to consider a different healthcare model. Should we put all our eggs in the vaccine basket? When we take the example of the flu vaccine, according to the CDC, “regular flu vaccine effectiveness varies and recent studies show that flu vaccination reduces the risk of flu illness by between 40% and 60% during seasons when most circulating flu viruses are well-matched to the flu”. (6) This may mean even less effectiveness when it’s not well matched. Although we can’t compare the flu virus to the corona virus, the problem with viruses is that there is such a high amount of mutation each year. And, RNA viruses, like the corona virus, tend to mutate faster than DNA viruses. (10) If this is the case, how effective will a corona vaccine be and can we rely on this as the sole strategy? This puts us in the position of continually chasing after a mutating virus. I’m not advocating for or against vaccinations, but we need more than a pharmaceutical option. What if we could create a host physiology that was inhospitable to a virus and able to combat a virus with a stronger defense system?
The good news is that we do have a better way to address “underlying health conditions” that can create both a terrain for the body to self-heal AND improve immune function. We can no longer ignore that diet and lifestyle heavily influence our health and consequently our ability to mount an appropriate immune response to an infection. (3,4.9) The field of functional medicine, functional nutrition and lifestyle medicine allows us to address these issues. It is a completely different healthcare model that takes a full body, mind and spirit approach to correct dysfunction and improve resilience, all of which we desperately need right now. This model helps us to make the connections between what we are eating, how we are sleeping, moving and managing stress with the symptoms we are experiencing. Working in this way helps to uncover the “roots” of a condition and create stronger foundations for all body systems. When a pot of water is boiling over, does it make sense to put a lid on the pot or shut the heat off at the source? A functional approach is looking for the heat source, while an allopathic or conventional approach may just be giving us bigger lids.
CoVID-19 is a disease of inflammation. Functional practitioners as well as allopathic practitioners, recognize that one of the primary root causes for most chronic health conditions is inflammation. (9) A functional approach gives us many nutritional and lifestyle tools to address and lower the inflammatory load in the body. We can bring in more nutrient dense foods to the diet, with an emphasis on fruits and vegetables, nuts, seeds, whole grains and clean protein sources like grass-fed meats, pastured eggs and wild caught seafood. We can address sleep and stress issues and get adequate exercise and movement in our day. We can clear up inflammation in the gut, where 70% of our immune system is located. We can drink clean water, filter our air and minimize exposure to things like EMF’s (electromagnetic fields), eliminate harmful substances in our environment like mold and hormone disrupting chemicals. We can eliminate the foods and substances that increase whole body inflammation. We can use targeted supplementation to bring deficiency to sufficiency. When we work this way, we not only bring inflammation down in the body, which may reverse the “underlying health conditions” but we allow the immune system to function more efficiently and effectively. We create a physiology that is strong and resilient, one that is better able to cope with the current pandemic and be prepared for a future crisis.
Functional medicine, nutrition and lifestyle practitioners see reductions and many times reversal of chronic disease in their practices every day. It is estimated that “80% of chronic diseases can be prevented by improving lifestyle behaviors, specifically smoking cessation, weight management, physical activity and a healthy diet.”(7) Recent findings show us that “unhealthy lifestyle behaviors are at the root of the global burden of non-communicable diseases and account for 63% of all deaths and a healthy lifestyle has repeatedly been shown to improve mortality”. (8) Dramatic effects using lifestyle interventions have been demonstrated in patients with chronic conditions, but the medical community is not embracing it…yet.
The bottom line is we can’t rely on the current medical model to help us out of this hole or depend on anyone to do this for us. As history has dictated, there will always be another virus or bacteria to challenge us. What’s required is that we become active health participants and educate our children in healthier lifestyles and nutrition to help us now and give future generations more and not less resilience. Most importantly, we have to be willing to step up and do the work. Herein lies the challenge, because our behavior and habits are often rooted and conditioned across multiple areas including the psychological, physiological, emotional, cultural, sociological and economical. Although there may be many challenges to overcome for real change, it is possible. Many only heed the wake-up call and overhaul their nutrition and lifestyle when diagnosed with a disease or terminal illness. Our wake-up call and time for overhaul is here. We owe it to ourselves, the workers putting their lives on the line and all those lost in this pandemic to learn a better way. We can do more than just social distancing, hand washing and waiting for a cure.
I hope this message leaves you with the hope that there may not only be a better approach to how we currently address chronic health issues, but in doing so, and as a result, will help us build the resilience we need to face current and future challenges. When we consider a different model of medical care, namely functional medicine, nutrition and lifestyle medicine, we address the principles and cornerstone of health and well-being. When we focus on prevention of chronic disease, we don’t need to wait for a vaccine to inoculate us, we can inoculate ourselves with whole foods, clean water, restorative sleep, exercise, social connection and stress management strategies. It’s time to change the medical paradigm. Let’s continue the conversation and take action together.
1. Abbasi, J., (2019) Medical Students Around the World Poorly Trained in Nutrition. Oct. 31. doi: 10.1001/jama.2019.17297 JAMA. 201 Online ahead of print.PMID: 31670744
2. Danek, R.L., et al. (2017) Perceptions of Nutrition Education in the Current Medical School Curriculum. Family Medicine. Nov;49(10):803-806.PMID: 29190407
3. Calder, P.C., (2002) The Immune System: A Target for Functional Foods? British Journal of Nutrition Nov;88 Suppl 2:S165-77. doi: 10.1079/BJN2002682. PMID: 12495459
4.Calder, P.C. (2013) Feeding the Immune System. Proceedings of the Nutrition Society. 2013 Aug;72(3):299-309.doi: 10.1017/S0029665113001286. Epub 2013 May 21.PMID: 23688939
5. Waters, H., Graf, M. (2018) The Costs of Chronic Disease in the U.S., Miliken Institute, August 2018
6. Centers for Disease Control and Prevention (CDC) . Vaccine Effectiveness: How Well Do the Flu Vaccines Work?
7. Ford, E.S., et al.(2009) Healthy Living Is the Best Revenge: Findings From the European Prospective Investigation Into Cancer and Nutrition-Potsdam Study. Archives of Internal Medicine, JAMA.. 2009 Aug 10;169(15):1355-62. doi:10.1001/archinternmed.2009.237.PMID: 19667296
8. Kushner, R.F. and Sorenson, K.W. (2013) Lifestyle Medicine: The Future of Chronic Disease Management. Current Opinion in Endocrinology and Diabetes & Obesity. 2013 Oct;20(5):389-95.doi: 10.1097/01.med.0000433056.76699.5d. PMID: 23974765
9. Bodai, B.I. et al.(2018) Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. The Permanente Journal. 2018;22:17-025. https://doi.org/10.7812/TPP/17-025
10. Sanjuan, R. and Domingo-Calap, P.(2016) Mechanisms of Viral Mutation. Cellular and Molecular Life Sciences. . 2016 Dec;73(23):4433-4448. doi: 10.1007/s00018-016-2299-6. Epub 2016 Jul 8. PMID: 27392606. PMCID: PMC5075021