Epigenetics:The Epicenter of the Future of Medicine

I have just finished writing  a new version of The Adaptation Diet (published by North Atlantic Books and to be released May 2013) which includes a new section on epigenetics, possibly the most important and powerful new information on how to lose weight and prevent chronic illness that I have seen in my 35 year medical career.  This new version of the book adds invaluable ideas on how to employ these new scientific breakthroughs in your daily life.

Epigenetics explores how genes that are carried in the DNA express their information. It is such a dynamic field that over 16,000 scientific articles are published every year and many academic medical institutions have established departments of epigenetics. Andrew Feinberg MD from Johns Hopkins University Center for Epigenetics wrote an article in JAMA in 2008 calling epigenetics the center of modern medicine.

Why is epigenetics so revolutionary?  In the past it was thought that whatever was inherited through the genes and DNA was fixed and unchangeable, our biological destiny written in the double helix of our DNA. One of the first clues that this was not so came from the world of honeybees. Scientists discovered that bees fed different foods as larvae became either workers or queen bees despite the exact same genetics. The differing diets of the larvae modified how their genes were expressed though a process called methylation which influences the structures around the genes and  which genes are turned on or off.

In humans, the greatest influence on methylation, as well as other epigenetic process(such as histone modification), is diet as well. What we eat, even what your mother consumed before you were conceived, can influence your gene expression and biological destiny. Obesity, and the risks of developing chronic disease including diabetes, heart disease and cancer are all a result of epigenetic phenomena. The greatest positive influence on epigenetic expression appears to be from what are termed bioactive foods including broccoli and other crucifers, soy, turmeric and other spices, garlic, green tea and folate rich foods such as green leafy vegetables.

However there are also many disruptive influences on gene expression caused by  changes in epigenetic states from exposure to environmental toxins such as BPA, PCB’s. phthalates and heavy metals. The interplay between adequate intake of bioactive foods and the amount of toxin exposure can determine so much about a person’s future health that I feel that epigenetic mechanisms are the most important focus in staying healthy.

I will write more about how to protect the epigenome and other new information from The Adaptation Diet in future posts including detailed information on bioactive foods and the toxins that have polluted the environment.

Lose Stress, Lose Weight

Sarah, a long-standing patient of mine was baffled. Despite eating well and exercising she had put on thirty pounds in the past two years, mostly around her midsection. In addition she was tired and achy, had poor sleep and worsening memory and concentration. And she was only thirty years old. The one thing that had changed in her life was a difficult divorce leading to on going stress with her ex husband and their two children.

Sarah is not alone in joining the ranks of the obese. Obesity is an epidemic that is sweeping the developed world. Excess weight is not only a risk for diabetes and heart disease, but recent research has shown obesity associated with increased cancer incidence and worse outcomes in those with cancer. Dietary habits are strongly linked to this new health challenge, especially the use of high glycemic foods (those that spike blood sugar), excess calories (supersized meals) and fats that stimulate inflammation (trans fats, baked goods, red meat and whole dairy not organically produced).  One common thread in all these dietary indiscretions is the effect on blood chemistry including elevating cortisol levels, the main stress hormone from the adrenal gland. (see The Adaptation Diet for more info.)However, as Sarah now knows, it is not diet alone that raises cortisol and increases the risk for obesity and disease. The other major trigger is chronic stress.

Cortisol is essential for life, without it survival would be impossible.  It is the main way we respond to any stress mobilizing energy through release of fatty acids, raising blood sugar, moving blood from the digestive system to the muscles. In addition cortisol suppresses the immune system, reduces inflammation and decreases sex hormone production. It is catabolic, breaking down muscle for energy. All these changes help survival, and normally after the stress is resolved, cortisol returns to baseline levels.

However, the stress we experience today and that experienced by our ancestors  and to which our body’s response is geared are different. In past generations stressful events were about survival: you either caught lunch or you were lunch. Today, whether the stress is a boss who does not respect you, a sick family member, a difficult relationship, or dealing with the onslaught of stimulation and lack of quiet time, the cortisol response does not resolve as it does after a fight or flight response.  Elevated cortisol continues to change the body and is associated with obesity, diabetes, heart disease, high blood pressure, depression, and increased cancer risks. This is what happened to Sarah.

To gain control over the stress response, Sarah used the information from Power of the Five Elements to understand her Adaptation Type. She learned that the anger and frustration she was carrying was so difficult to let go of because  she was a Wood Adaptation Type who has a very hard time with forgiveness and patience. Once she was able to see her behavior through this ‘map’. she followed exercises to enhance her ability to forgive and reduced her cortisol and eventually lost the extra pounds as well as learning to feel better about herself.

Forgiveness and Health

One reason I wrote Power of the Five Elements was to bring to light some startling new research on the effects of long term stress on health. Bruce McEwen and other researchers found that once someone has been exposed to chronic  stress the brain actually resets the amount of stress hormone secreted. This leads to possible serious consequences such as diabetes, heart disease and cancer. The price one pays to adapt to stress is called allostatic load, something to avoid at all costs.

Luckily certain innate or acquired attitudes and behaviors such as forgiveness, leads to lower stress hormones and less damage to the body. In one study researchers measured  blood pressure and heart rate of seventy-one college students while they were thinking of times they had been lied to, insulted, or betrayed by family member. When they imagined forgiving the people who had wronged them, their blood pressure and pulse rate dropped dramatically.

By following these behavioral tips, it is possible to reduce the risk of chronic disease.


Mediterranean Diet and inflammation

In an recent study done at the University of Navarra in Spain, 41 obese subjects were placed on a low calorie Mediterranean style diet and followed for 8 weeks. Those who adhered most closely to the diet not only had the greatest weight loss, but had a marked reduction in blood levels of inflammation including CRP, complement C3 and TNF alpha. The conclusion of the researchers was that this type of diet, which I outline in The Adaptation Diet, not only helps with weight loss but can markedly reduce inflammation and improve features of the metabolic syndrome and other inflammatory conditions.

We often underestimate the effect of diet on metabolism and overly rely on medication instead. So before reaching for the prescription pad, give yourself a chance to improve your health by following The Adaptation Diet.

Power of the Five Elements

I have a new book coming out, Power of the Five Elements; The Chinese Medicine Path to Healthy Aging and Stress Resistance. It can be pre-ordered from North Atlantic Books and will be released April 6th,2010. Based on my thirty years of medical practice, Power of the Five Elements presents the Five Adaptation Types, a modern application of the Five Elements of Chinese medicine to reduce the stress response and prevent chronic disease.

The five types allow readers to identify through questionnaires and case histories their own energetic patterns for adaptation and to create strategies for reducing stress and improving health. Focusing on the fact that maintaining health and preventing stress-induced diseases such as heart disease, diabetes, and cancer, requires adapting successfully to changing circumstances, Power of the Five Elements offers a range of behavioral changes and exercises such as meditations and visualizations to enhance adaptive responses. It is essential reading for anyone under stress or at risk for chronic disease.

Mediterranean Diet and health

Dietary patterns close to the Mediterranean diet, rich in fruit and

vegetables and high in monounsaturated fats, reduce  features of the metabolic syndrome. The metabolic syndrome, also called syndrome X, includes high blood pressure, insulin resistance, truncal obesity (fat around the waistline),high triglycerides and blood sugar, and low HDL cholesterol. It is a major risk factor for heart disease and diabetes. Some recent studies, including one done by Balbio in Spain,  have demonstrated a 25 percent net reduction in the prevalence of metabolic syndrome following lifestyle changes mainly based on nutritional recommendations.

The Mediterranean Diet has the following characteristics:

Low-glycemic-index carbohydrates such as whole grains, fruits, and vegetable in large amounts

Minimal snacking between meals and no fast foods

Moderate consumption of red wine (5 ounces per day)

Olive oil as the principal fat, with significant amounts of fish, nuts,

and seeds and a balanced omega 6 to 3 ratio

Significant intake of fish, especially salmon and small fish like

sardines rich in EPA-DHA fatty acids

Little saturated fats from butter, cream, full-fat dairy, or red meats

Protein primarily as beans and lentils with moderate amounts of fish and poultry

Dairy consumed as low-fat yogurt, kefir, or cheese

Fat consumption is 25–35 percent of calories, with saturated fat less than 8 percent

Desserts are fruits, often fresh

Use of local produce, fish, and poultry with minimal importation from distant sources

Slow food approach, eating leisurely meals in a social setting with family and friends

These are some of the principles included in The Adaptation Diet, available early February from on-line book sellers.