Why Doctors Don't Discuss Diet & Lifestyle Change

The Centers for Medicare and Medicaid Services (CMS) 2022 National Quality Strategy is described as an "ambitious long-term initiative that aims to promote the highest quality outcomes and safest care for all individuals." This sounds great, and it would be if there were any possible way for this initiative to fulfill its promise. But, as with many programs operated by the government, high-quality outcomes are not likely to occur..

Most doctors and most patients know that diet, exercise, hydration, sleep, and other lifestyle factors are important determinants of health. Clinical practice guidelines for many conditions include recommendations that diet and lifestyle intervention should be the first and is the best treatment. Many studies have shown that type-2 diabetes can be reversed with a whole food plant-based diet (WFPB).[1] [2] Long-term adherence to a WFPB diet has been shown to result in atherosclerotic regression, reduction in angina and reduced risk of cardiac events, even in people who have been diagnosed with severe coronary artery disease.[3] [4] 
 
So why aren’t more doctors spending more time during office visits to discuss these types of health improvement strategies with their patients? The answer might surprise you. Quality measures used to evaluate the performance of doctors and reimbursement schedules do not take into consideration issues such as improved health outcomes and reduced costs of care. For example, adherence to medication is rewarded, even if the patient does not experience any health improvement at all. Diet and lifestyle education requires more time than most medical institutions allocate for patient visits, which further incentivizes prescribing instead of engaging in meaningful discussions about health.

Thus, in most cases, patients are not informed about diet and lifestyle change as an option or an alternative to medication. A commonly held misconception is that most Americans would rather just take a pill than change their diet and increase their exercise. But the reality is that this choice, along with the risks and benefits of both options, is not presented to most patients most of the time.

Lifestyle medicine is now a medical specialty, and since certification began in 2017, 2500 physicians have become board-certified. In addition to the limitations already mentioned, a survey found that over half of lifestyle medicine clinicians receive no reimbursement for offering such services. And some programs that are eligible for reimbursement offer so little money that clinicians cannot afford to spend time on them.[5]

One program that is reimbursed adequately is intensive cardiac rehabilitation. It’s underutilized and one of the reasons may be that patients are required to co-pay for visits. For the program to work, visits need to be scheduled frequently, increasing the expense to patients, and creating yet another barrier to real health improvement.

One of the best illustrations of just how dysfunctional the current system has become is what happened to a lifestyle medicine family practice physician who prescribed lifestyle change instead of a statin drug to a patient with hyperlipidemia. Within just three weeks, total cholesterol dropped from 226 mg/dl to 171 mg/dl and triglycerides dropped from 132 mg/dl to 75 mg/dl. This was obviously a great outcome for the patient. But the CMS 5-Star Rating System assigned the physician a Grade C, which placed the doctor’s previous 5-star rating at risk. The reason was that scores are largely based on medication compliance. The physician was penalized even though the outcome was much better than would be expected from treatment with a statin.[6]

There are other ways the system can punish doctors for curing people. The sicker the patient, the higher the reimbursement rate from Medicare, because it is assumed that care will cost more. The physician who reverses type 2 diabetes with diet is penalized because diabetes is no longer listed as a condition the patient has, so Medicare pays the doctor less money. In other words, Medicare pays doctors to manage, not reverse disease.[7]

There are now over 2500 quality measures for doctors to pay attention to, and curing people is not one of them. This sad state of affairs reinforces our advice that consumers must take responsibility for their health and should not outsource decisions about treatment to their doctors.

[1] Anderson JW. "Dietary fiber in nutrition management of diabetes."  In: G. Vahouny, V and D Kritchevsky (eds), Dietary Fiber: Basic and Clinical Aspects."  Pp.343-360. New York: Plenum Press,1986.
[2] De Natale C, Annuzzi G, Bozzetto L et al. "Effects of a Plant-Based High-Carbohydrate/High-Fiber Diet Versus High–Monounsaturated Fat/Low-Carbohydrate Diet on Postprandial Lipids in Type 2 Diabetic Patients." Diabetes Care 2009 Dec;32(12):2168-2173
[3] Ornish D, Scherwitz LW, Billings JH et al. "Intensive lifestyle changes for reversal of coronary heart disease." JAMA 1998 Dec;280(23):2001-2007
[4] Esselstyn CB, Ellis SG, Mendendorp SV, Crowe TD. "A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physicians’ practice." J Fam Practice 1995 Dec;41(6):560-568
[5] Padmaja Patel MD. How PCPs Are Penalized for Positive Outcomes From Lifestyle Change. Medscape October 13 2023
[6] IBID
[7] IBID
Pam Popper Wellness Forum Health

The Ketogenic Diet Explained

There are many misunderstandings about the ketogenic diet, ranging from the conditions for which it can be useful to the right way to adopt it. Many people claim to be eating a ketogenic diet who are not doing so, and many of the claims currently being made about the diet are patently false.

The ketogenic diet is a high-fat, low-carbohydrate diet that has been used since 1921 as an effective treatment for several forms of epilepsy. While primarily used for children, there is some evidence that some epileptic adults may benefit too. The best experts on the diet are at Johns Hopkins Children’s Center.

The mechanism of action that explains the efficacy of the ketogenic diet is that it mimics a fasting state, and fasting has been known to be an effective treatment for seizures since ancient times.[1] Within a short time after beginning a fast, the body stops using glucose and converts to using stored fat for fuel, a state known as ketosis. During ketosis, ketones are produced, which are useable as a substitute source of energy for both the body and brain. The ketogenic diet results in the same effect. Restricted carbohydrate intake results in burning dietary fat for fuel, which allows for an extended period of time in a fasting state. Fat stores are used up within a relatively short period time, while living off of dietary fat intake can continue for much longer periods of time.

Research shows that the diet works when implemented properly. A 2001 study at Johns Hopkins showed that 75 out of 83 epileptic children who consumed a ketogenic diet for a year had either partial or full resolution of their symptoms and improvement was sustained after stopping the diet.[2]

In another study, 65 epileptic children between 18 and 24 months of age were assessed before starting and after one year on the diet. For those who remained on the diet (52%), mean seizure frequency decreased from an average of 25 seizures per day prior to the diet to less than 2 per day, and was accompanied by significant improvements in both attention and social functioning.[3]

A meta-analysis of 11 studies showed that 16% of children experienced complete resolution of seizures, 32% experienced a 90% reduction, and 56% had a greater than 50% reduction in seizures.[4]

While ketogenic diets can be effective, there are side effects. One study of pediatric patients treated with the Johns Hopkins protocol showed that during the first 4 weeks, dehydration and gastrointestinal complications were common, and infectious diseases, aspiration pneumonia, hyperuricemia, hypoglycemia, electrolyte imbalances, acidosis, hepatitis, and acute pancreatitis have been reported. After 4 weeks, patients remain prone to all of these complications except dehydration, pancreatitis, and hyponatremia. In almost 15% of patients, osteopenia, kidney stones, hydronephrosis, iron deficiency anemia, and cardiomyopathy developed after one month in ketosis. Some patients dropped out of the study due to the side effects of the diet.[5] Vomiting, constipation, kidney stones and an increase in plasma cholesterol are common. Kidney stones can be prevented by supplementing with potassium citrate, and cholesterol levels return to normal after the diet is stopped.[6]

The bottom line is that while the diet is effective for most children who adopt it, there are side effects, and patients must be carefully monitored while using the diet for medical treatment. The diet is only adopted for a short period of time, and for many parents of epileptic children, the benefits outweigh the risks since drugs used to treat epileptic children are often ineffective and have even more side effects.

Interest in ketogenic diets has increased recently, in part because of the positive effects fasting has been shown to have on cancer patients. Animal studies have shown that fasting is effective for reducing the side effects of chemotherapy, and for decreasing circulating IGF-1 levels, a known risk for cancer.[7]  The same effect has been shown in human subjects.[8] Fasting can be an effective strategy for both preventing and treating cancer because cancer cells are weakened and normal cells are strengthened in response to food restriction.[9] The reason is that humans have historically lived for long periods of time with limited food and sometimes no food at all. Normal cells are adept at surviving under these circumstances, converting to burning ketones for fuel, while cancer cells cannot live on ketones.

Water-only fasting can be undertaken by many people for a few weeks, and obese people can fast for several months. But people cannot fast indefinitely, and some aggressive cancers, particularly brain cancers like glioblastoma, do not completely resolve after a few weeks of fasting. Traditional treatments are notoriously ineffective for these patients, who have grim prognoses and usually only a few months to live after diagnosis.

Thomas Seyfried, Ph.D., has spent his career studying the use of metabolic therapies to manage mainly chronic and difficult-to-treat conditions like epilepsy and brain cancer. In his book, Cancer as a Metabolic Disease, he provides extensive documentation showing that cancer is not a genetic disease, but rather a mitochondrial metabolic disease. This is not a new idea, but one that was largely forgotten as very profitable cancer treatments such as surgery, chemotherapy and radiation became standard practices. He proposes the use of several therapies which include calorie restriction, fasting, and a ketogenic diet for addressing difficult-to-treat cancers. He presented a lecture on this topic during our 2016 conference, citing a few case reports, one of whom was a woman who lived for 7 ½ years after her diagnosis, almost unheard of for glioblastoma patients.

And this brings me to the current misunderstandings about the ketogenic diet, which originate both from those who advocate a plant-based diet and those who promote Paleo and other diets.

First, the Paleo diet and the Atkins diet are not ketogenic diets. Just eating animal foods while restricting grains and beans, or eating a high-saturated fat diet will not result in ketosis, which is required for the diet to have any therapeutic effect. A ketogenic diet requires the assistance of well-trained professionals because the macronutrient make-up of the diet must be exact and consistently maintained. A keto monitor is required, and patients must test themselves several times per day to make sure they remain in ketosis.

Second, due to the side effects of the diet, some of which are quite serious, the ketogenic diet should only be adopted by patients for whom the benefits outweigh the risks. For example, a glioblastoma patient with only a few months to live is better off staying alive while taking potassium supplements to avoid kidney stones than dying with low plasma cholesterol levels. On the other hand, the risks of side effects from the ketogenic diet are not warranted for a person who wants to lose weight or reverse type 2 diabetes. Low-fat, plant-based diets have been proven to be effective for these purposes without the negative side effects.

On the other hand, advocates of plant-based diets can become almost apoplectic when the ketogenic diet is mentioned for treatment. A diet high in fat and that restricts healthy carbohydrate foods like potatoes seems like heresy to them. They think that a very low-fat plant-based diet is the answer for everything. It’s the answer for a lot of things, but not everything. Those who take this stance - a one-size-fits-all approach to treating patients - are both practicing reductionism and abandoning the use of clinical judgment, which is desperately needed in the practice of medicine today. People are not all the same, and their age, limitations, medical history and current state of health must all be considered when making any health-related recommendations, including those concerning diet.

Dietary advice must be tailored to the particular condition of the patient, and often must be combined with other treatments that include dietary supplements, cognitive therapy, exercise, physical therapy, and some conventional treatment. It is important to avoid dogmatic adherence to ideas, and to think outside the box as we seek solutions for our healthcare crisis.

In summary, the ketogenic diet is an option to be considered for very specific situations for a very small percentage of people. It requires a rigorous and disciplined approach in order to be effective, and almost always involves hiring an expert for assistance. The diet has serious side effects, which should be disclosed to patients before adopting the diet, and which make it a good choice only when the potential therapeutic benefit outweighs the risks.

[1] Huffman J, Kossoff E. "State of the ketogenic diet(s) in epilepsy." Curr Neurol Neurosci Rep 2006 Jul;6(4):332-340
[2] Freeman J, Kossoff E. "Ketosis and the ketogenic diet, 2010: advances in treating epilepsy and other disorders." Adv Pediatr 2010;57(1):315-329
[3] Pulsifer M, Gordon J, Brandt J, Freeman J. "Effects of ketogenic diet on development and behavior: Preliminary report of a prospective study." Dev Med Child Neurol 2001 May;43(5):301-6.
[4] Lefevre F, Aronson N. "Ketogenic Diet for the Treatment of Refractory Epilepsy in Children: A Systematic Review of Efficacy." Pediatrics 2010 Apr;105(4)
[5] Kang H, Chung D, Kim D, Kim H. "Early- and late-onset complications of the ketogenic diet for intractable epilepsy." Epilepsia 2004 Sep;45(9):1116-1123
[6] Freeman J, Kossoff E. "Ketosis and the ketogenic diet, 2010: advances in treating epilepsy and other disorders." Adv Pediatr 2010;57(1):315-329
[7] Lee C, Safdie FM, Raffaghello L, et al. "Reduced levels of IGF-I mediate differential protection of normal and cancer cells in response to fasting and improve chemotherapeutic index." Cancer Res 2010 Feb 15;70(4):1564-72
[8] Safdie F, Dorff T, Quinn D et al. "Fasting and cancer treatment in humans: A case series report." Aging (Albany NY) 2009 Dec; 1(12): 988–1007.
[9] Brandhorst S, Longo V. "Fasting and Caloric Restriction in Cancer Prevention and Treatment." Recent Results Cancer Res 2016;207:241-266


Collagen


Your Wellness Lifestyle Starts Here

Collagen-we are hearing about it a lot and it seems to be popping up in a lot of products, with marketers telling us how much we need it. So, what is it, how does our body make it, and do we need to supplement? Can we get heathier skin, nails and more by consuming collagen peptides?  Let's take a look at what the research and the science say.

What Is Collagen?

Collagen is a group of “hard, insoluble, fibrous” proteins that give structure to connective tissue and constitute about one-third of your body’s protein. Over two dozen types of collagen have been identified; these are the three most prominent types:
  • Type I, found in the skin, tendons, teeth, internal organs, and bones
  • Type II, found in the eyes and cartilage
  • Type III, found in the skin, muscles, bone marrow, lymphoid tissue, and blood vessels
Ligaments, hair, and protective membranes around organs also contain collagen.
The body forms collagen from amino acids, mainly proline, glycine, lysine, and hydroxyproline, and other nutrients, including vitamin C, zinc, copper, and manganese.

Are There Scientifically Proven Benefits to Consuming Collagen?

Some research suggests that collagen supplements confer benefits:
  • improved skin health and appearance, including better elasticity, increased hydration, and fewer wrinkles[1][2]
  • less joint pain and stiffness for osteoarthritis patients[3]
  • faster wound healing[4]
  • increased muscle mass when paired with resistance training[5]
  • increased bone mineral density[6]
However, not all studies have found similar benefits, and many (if not most) of the studies that report benefits are funded by companies selling collagen supplements. It’s also not uncommon for studies like these to include additional supplements that muddle the results. For example, in one of the studies on skin referenced above, the treatment group received a blend of collagen peptides, acerola fruit extract, vitamin C, zinc, vitamin E, and biotin.[1] The placebo, however, contained no nutrients. How are we supposed to know the extent to which the collagen supported the observed outcomes, if it did at all?
As reported in a 2022 systematic review, several studies have also reported adverse effects and low efficacy compared to routine treatments.[7] They conclude, “risk of bias assessment showed that most of the studies had poor quality. Further studies are needed to reach a final decision.”
Because the body breaks collagen down into its constituents, including amino acids, it’s also unclear whether the apparent benefits of collagen supplements come from the collagen as a whole or merely from its amino acid components, which can be obtained more effectively from whole foods.

Another thing you may have seen is collagen boosters, which are supplements containing the building blocks your body uses to produce collagen. Putting aside the obvious fact that you can get all the necessary building blocks from whole foods, these collagen boosters are not without their risks. Like all supplements in the US, they are barely regulated by the FDA. They may not contain the amounts and types of nutrients listed on their labels; they may be contaminated with heavy metals and other environmental toxins; and because toxins accumulate higher up the food chain, animal-derived collagen peptides may have even more toxins than the average supplement.

How Can I Increase Collagen Production Naturally?

Eating foods containing the amino acids and nutrients from which collagen is formed provides your body with the raw materials for making more collagen without supplements. You can find these raw materials in whole plant foods: legumes, nuts, seeds, fruits, vegetables, and whole grains.
Most likely, you do not need to concern yourself about collagen production if you take the following steps:
  • Consume enough protein for your activity level (this will not be a challenge if you get enough calories).
  • Eat leafy greens and other colorful fruits and vegetables for plenty of vitamins and minerals.
  • Add hemp and pumpkin seeds, cashews, and other high-zinc nuts and seeds to your meals.
  • Enjoy plenty of beans, root vegetables, and whole soy products in your diet to increase your intake of hyaluronic acid, a component of the collagen in the skin.
Additionally, you can preserve the collagen you already have by avoiding unhealthy lifestyle choices and non-whole plant-based foods, including oils, that increase free radical production or inflammation. Avoid excessive UV exposure and don’t smoke.
If you follow these recommendations and eat a wide variety of whole plant foods, your body should produce all the collagen it needs without any of the risks associated with collagen supplements. If you have an underlying condition affecting your collagen production, speak to a qualified physician to address the root cause.

References:
Theresa Houghton, Center for Nutrition Studies
  1. Bolke L, Schlippe G, Gerß J, Voss W. A Collagen Supplement Improves Skin Hydration, Elasticity, Roughness, and Density: Results of a Randomized, Placebo-Controlled, Blind Study. Nutrients. 2019;11(10):2494. Published 2019 Oct 17. doi:10.3390/nu11102494
  2. de Miranda RB, Weimer P, Rossi RC. Effects of hydrolyzed collagen supplementation on skin aging: a systematic review and meta-analysis. Int J Dermatol. 2021;60(12):1449-1461. doi:10.1111/ijd.15518
  3. Lugo JP, Saiyed ZM, Lane NE. Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: a multicenter randomized, double-blind, placebo-controlled study. Nutr J. 2016;15:14. Published 2016 Jan 29. doi:10.1186/s12937-016-0130-8
  4. Bagheri Miyab K, Alipoor E, Vaghardoost R, et al. The effect of a hydrolyzed collagen-based supplement on wound healing in patients with burn: A randomized double-blind pilot clinical trial. Burns. 2020;46(1):156-163. doi:10.1016/j.burns.2019.02.015
  5. Zdzieblik D, Oesser S, Baumstark MW, Gollhofer A, König D. Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: a randomised controlled trial. Br J Nutr. 2015;114(8):1237-1245. doi:10.1017/S0007114515002810
  6. König D, Oesser S, Scharla S, Zdzieblik D, Gollhofer A. Specific Collagen Peptides Improve Bone Mineral Density and Bone Markers in Postmenopausal Women-A Randomized Controlled Study. Nutrients. 2018;10(1):97. Published 2018 Jan 16. doi:10.3390/nu10010097
  7. Jabbari M, Barati M, Khodaei M, et al. Is collagen supplementation friend or foe in rheumatoid arthritis and osteoarthritis? A comprehensive systematic review. Int J Rheum Dis. 2022;25(9):973-981. doi:10.1111/1756-185X.14382
  8. Reisdorf A. Here’s what you need to know about vegan collagen. Healthline. Updated March 8, 2019. https://www.healthline.com/health/food-nutrition/vegan-collagen






What the Healthcare?

By now you have all heard of the murder of the CEO of United Health Group. The rumors speculated that the shooter's mother was turned down for certain medical needs. Neither the shooter nor his mother had coverage with this company. The truth is that the shooter targeted UHG because they are the largest "healthcare" insurance company in the U.S. The shooter alleges in his "manifesto" that they represent corporate greed, and the CEO was targeted as a symbolic takedown. 

I use the term "healthcare" for insurance companies loosely. I call it sick care. Granted, who loves medical insurance companies? Look what a behemoth they have become and who can afford them? How did it get this way? How did insurance companies and pharmaceutical companies take over "healthcare". Fixing this will take a lot of time but we cannot put our hopes on anyone to fix it with a magic wand. We need to be proactive regarding our health. 

 Today’s healthcare system is not about health. It’s about selling a never-ending series of tests, drugs, and procedures to people. “Alternative health” is about selling different tests, supplements, and procedures to people. In order to maximize sales, tests and treatments need to be marketed to the general population, with no consideration about whether or not most people are actually candidates for or can benefit from the services promoted.

Advertising helps to promote all of these ideas. Insurance companies send reminders about “regular checkups.” Billboards in airports promote the idea that testing for a growing list of cancers saves lives. Television ads tell consumers that every negative emotion people experience, however normal or fleeting, is a diagnosable condition and drugs are available to treat it. Symptoms like frequent urination, pain, constipation – these are all things that require intervention by highly skilled physicians who can treat them with drugs.

Being sucked into the medical mill is how the medical establishment generates business, and most important, repeat business. Once taught that every symptom requires intervention, every abnormal biomarker is a sign of disease, and anything even a little unusual means a specialist should get involved, the now "well-trained" consumer comes back again and again. This consumer is hyper-focused on every small sign or symptom, convinced that it is an indication that treatment is needed. Also, the consumer is taught to be grateful that various “conditions” have been successfully diagnosed and treated (NSAIDS or COX-II inhibitors have stopped the pain, SSRI’s have relieved the negative emotions, hormone therapy has stopped the hot flashes, PSA testing or mammography has diagnosed “cancer” early, etc.). Of course, this leads to even more tests and treatments. The main reason that cancer screening remains a booming business is not because it “saves lives,” but rather due to economics. It is estimated that the screening business generates $80 billion dollars in sales annually in the U.S, and screening is the best way to recruit patients for the cancer treatment industry which generates hundreds of billions of dollars for medical centers annually.

The insanity is that while this goes on, the patient usually experiences visible declining health. Over 70% of Americans are overweight or obese. Most are sedentary. Most eat a terrible diet. They don’t look good and they certainly do not feel good overall. And during the never-ending interactions with doctors, there is almost no discussion about these issues, or their cause. Americans are seeing more doctors for more tests and treatments than ever before, while they get sicker. Both doctors and patients seem to be oblivious to the irony of the situation.

The medical establishment knows that humans do not like to experience discomfort, which is why their marketing campaigns work. They promote the idea that people can avoid the hard work of taking care of themselves by signing up for tests and treatments instead. Medical care essentially makes consumers passive participants in their own lives. While it’s a bad idea, it’s an enticing idea, and one that can be difficult to resist. Hence, many people become “addicted” to medical care and can have difficulty “withdrawing” from the hyper-focused, quick-fix mentality. 

I’m not suggesting that people avoid all interactions with doctors or healthcare. If I had a pain in my side that did not resolve in the next few days, I’d have it checked out. This is common sense. But aside from the obvious need for care from time to time, gain some confidence in your body’s ability to achieve health. And gain some resilience for dealing with discomfort. It’s part of life. And it’s certainly part of healing.

What else can we do? What commitments can you make to yourself in 2025 besides the obligatory resolutions like "losing weight" or "getting healthy"? Neither of those have a specific plan of action to accomplish the resolution.

For starters, become an Informed Consumer. Learn how to filter information regarding your health. Learn what the risks and benefits are of any medical intervention suggested by your doctor. 

Stating that you are going to lose weight and get healthy without a strategy leads to failure. Our objective is to help you learn how to remain or to become a healthy person. Optimal health is achieved and maintained when people practice proactive and intentional health care.

We remain committed in 2025 to helping you learn the tools to achieve optimal health and to stay out of the medical mill.



Liz Fattore
Licensed Food Over Medicine Instructor
Wellness Forum Health 



Resources: Wellness Forum Health



Thoughts on Chef AJ's Cancer Diagnosis

I recently listened to Chef AJ's heartbreaking announcement of her lung cancer diagnosis. If you are not familiar with her, she is a renowned plant-based chef and author and created the Ultimate Weight Loss Program. (Learn more at www.chefaj.com) What was even more heartbreaking was that since the original diagnosis in 2022, she delayed sharing the news for fear of backlash from her followers and others in the health and plant-based fields. She is a public figure in the field of health and wellness and the stress of having that hanging over her head while coming forward must have been daunting. 

Her lung cancer was detected during a scan for another health issue. It's what we call an "incidentaloma", something that is found while looking for something else. She was misdiagnosed with Interstitial Cystitis, a chronic disease affecting the urinary bladder.  She was being treated for 100 days when finally, a test revealed that she had a raging UTI. Six months later, a chest scan revealed the tumor on her lung. You can listen to the whole story here (https://www.youtube.com/live/36XThEsfLCg?si=rtDGBNrcYQnhYNIW).

Her fear of revealing her diagnosis and being judged has caused her much anxiety. She also was brave enough to share that anxiety and stress has been a major issue for years. It sounds like she is doing all the right things, surrounding herself with support from friends, especially for her mental health. She is equipped with the resources to get her through the treatments. I was glad to hear that she went to True North Health for a water fast. Water fasting should always be supervised and the recommended 4-5 days fast will put your body in ketosis and put the cancer cells in apoptosis (death).  This process facilitates the job of chemotherapy. 

Her friend Dr. Matt Lederman, who was her guest on the above video, stated that we are all walking around with cancer cells. Our bodies are bombarded daily with toxins from unhealthy food, the air we breathe, the environment we live in, etc. I have talked about this fact when teaching on the immune system. Our cells, when in contact with these toxins, start to mutate and form tumors. This can take years and years. There are an enormous number of mutations that occur. Our cells, however, have numerous mechanisms to repair these mutations. There are over 100 known DNA repair genes.  

Should we all be walking around in fear? Of course not! Knowing the risk factors will help you make decisions about your health. Look at your diet, weight, alcohol consumption, prescription drugs, chemicals/pollution, diabetes, smoking, stress/psychological state, and social isolation. Diseases like cancer, heart disease, diabetes, etc. don't just grow overnight. They are a result of your diet and lifestyle and the listed risk factors. Diet and lifestyle are the most important thing to do to give yourself the best chance at keeping disease at bay and also to help you get through a diagnosis. If you eat healthy long enough, that becomes your preferred way of eating. It doesn't need to be perfect; it just needs to be consistent. It's the totality, the breadth, of your eating pattern that makes the difference. 

 Chef AJ has a very healthy eating pattern. Her diet is the foundation which will help her get through her treatments. Her self-confessed anxiety could have played a role in her diagnosis, but I am not here to guess what is going on in her life. She is very stressed about her husband being her caregiver. As she said, "anxiety is driving the bus", which is why she is getting counsel for her emotional and spiritual health. 

Our emotional and spiritual health have a profound effect on healing our bodies.  This is a concept that has its roots in early Jewish culture. When the greeting "Shalom" was extended, it was wishing the person total health in body, mind and spirit. They recognized the connection in all three areas. 

I highly recommend Kelly Turner's book "Radical Remission" to anyone with a cancer diagnosis. She outlines the factors that are important in surviving a cancer diagnosis. Not only radically changing your diet, but other factors such as releasing suppressed emotions, increasing positive emotions, deepening your spiritual connection, and having strong reasons for living are discussed. Turner states in her book that the mind leads the body. When you have a strong thought or emotion, powerful hormones are released instantly into your bloodstream; they either have a beneficial or detrimental effect on your immune system, depending on the nature of that thought or emotion.

Stress is a particular emotion that has a negative effect on the body. While stress is a normal bodily function and an inevitable part of daily life, chronic stress and its effects can be destructive. Stress weakens the immune system and can negatively affect every cell in your body. Chronic stress can aggravate inflammation in the body. The body and the mind are not separate!

Speaking of stress and transparency, I have shared with some of you my husband's diagnosis of Parkinson's Disease. It has been over 2 years of doctor's appointments and a life altering experience. He has had other health issues that are Agent Orange (the "gift" that keeps on giving) related. Most have been reversed (cancer) and manageable. But not this. Parkinson's is a neurodegenerative disease for which there is no cure and is "managed" with dopamine agonists, a drug with many side effects. I am not the one with the disease, I am the caregiver, which comes with its own set of stressors. I can understand AJ's concern for her husband's role as caregiver. however, she has the capacity to advocate for herself with her doctors. My husband is in a continuous cognitive decline, which leaves me to manage his healthcare, as well as everything that entails. It leaves me to manage the house and finances. It leaves me to make all decisions for both of us. It is overwhelming and exhausting. I grieve many losses every day. This definitely was not what we had in mind for our "golden" years.  My friends ask me how I am doing all of this. I am not. I can't do it but for the grace of God who gives me strength. It is exactly like AJ said. It is not one day at a time. It is one moment at a time.

I am grateful that I have the tools in my "toolbox" to use to get through the moments. I know that I need to maintain the optimal way of eating for the both of us to keep my immune system strong. I am learning to ask for help. I have caregivers so that I can go to church and to the gym to manage the stress and to give myself some much need respite. I have a wonderful therapist. I have good friends who check up on me. Hearing their voice or reading their text messages lift my spirits. They get me through the moments. The most difficult part lately is getting quality sleep as this is almost a 24/7 job. When I feel the stress, I escape for some deep breathing, for prayer, for scripture reading, and a good cry, 

It is important to stay focused on the connection of body, mind and spirit. Respect your body, walk away from anything or anyone who is toxic in your life (cortisol creators). Become aware of what you are putting in your body and your mind. Look for the incentives to change any bad habits. As Thomas Fuller states "health is not valued until sickness comes".

Liz Fattore
Nurture Your Health
Licensed Food Over Medicine Professional
www.lizfattore.com


 
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