A new practice model

 Learn how to reverse metabolic syndrome by applying a lifestyle medicine program.

By Mark A. Kaye, DC

Obesity isn’t the only epidemic in the U.S. today. One-third of all adult Americans are at an increased risk of heart disease and diabetes, among other chronic illnesses, because they have a condition known as metabolic syndrome. Typically, poor lifestyle choices contribute to this growing problem, but it is preventable.

Major health organizations have recommended guidelines of 12 weeks of lifestyle therapy for the prevention or management of metabolic syndrome and patients who are at risk for heart disease and diabetes.

Although many chiropractors are receptive to using lifestyle modification approaches in their practices, most are still unable to comply with these guidelines because they do not have the time, the training, the tools, or a reimbursement model to help patients make significant, permanent changes in lifestyle that will get and keep them healthy.

A growing new practice model including a lifestyle medicine program plus a medical food¹ can help you reverse metabolic syndrome in your patients.

What is metabolic syndrome?

Metabolic syndrome is a cluster of symptoms that increase the risk for cardiovascular disease (CVD) or type 2 diabetes mellitus (T2DM) and is diagnosed when at least three of the following are present:

1. Elevated waist circumference: equal to or greater than 40 inches (102 cm) in men and equal to or greater than 35 inches (88 cm) in women.
2. Elevated triglycerides: equal to or greater than 150 mg/dL.
3. Reduced HDL (“good”) cholesterol: less than 40 mg/dL in men and less than 50 mg/dL in women.
4. Elevated blood pressure: equal to or greater than 130/85 mm Hg or use of medication for hypertension.
5. Elevated fasting glucose: equal to or greater than 100 mg/dL (5.6 mmol/L) or use of medication for hyperglycemia.

In addition to increasing susceptibility to cardiac events^2-5 and diabetes, metabolic syndrome increases risk of non-alcoholic fatty liver disease, a condition that is rising in prevalence in Western countries and is associated with an increased risk of cirrhosis, liver cancer, and liver failure.⁶ Also, the incidence of certain malignancies, including colorectal and prostate cancer, increases with the presence of metabolic syndrome.^7-10 Polycystic ovary syndrome, the most common endocrinopathy of reproductive-age women,¹¹ is strongly associated with metabolic syndrome.¹² Furthermore, sexual dysfunction,¹³ gout,^14,15 chronic renal disease,16 and microalbuminuria¹⁷ have each been associated with metabolic syndrome.

Approximately 34 percent of adults in the U.S. meet criteria for metabolic syndrome diagnosis,¹⁷ and individual propensity for developing metabolic syndrome increases dramatically with age.¹⁸ Due to the prevalence of obesity and the aging population, and given the relationship among metabolic syndrome, T2DM, and CVD, a long- term solution is urgently needed.

Refocusing practice treatments on the provision of lifestyle medicine will not only significantly improve the health status of most patients, but will reduce the $1.5 trillion spent annually in the U.S. in order to treat chronic illness, which affects nearly half of all adults and contributes to seven out of 10 deaths. Although pharmaceutical treatment options are available for managing symptoms related to metabolic syndrome, lifestyle change programs treat the root causes of metabolic syndrome and chronic illness.

What is a lifestyle medicine program?

Principles of lifestyle changes are the foundation of most practices. Research has shown that patients who incorporate a medical food into their diets, as well as make necessary lifestyle changes can improve their health quickly and safely.

A medical food is specifically formulated to nutritionally manage conditions associated with certain disease states. The U.S. Food and Drug Administration (FDA) defines medical foods as:

• Formulated to be consumed under the supervision of a physician.
• Intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.

The Journal of Clinical Lipidology¹⁹ reported results of a 12-week multi- center clinical trial conducted by the University of Connecticut, the University of Florida, and the University of California at Irvine, which indicated that a lifestyle medicine program with a medical food²⁰ combined with a low-glycemic, Mediterranean-style diet significantly outperformed diet alone in reducing several risk factors for cardiovascular disease: total cholesterol, triglycerides, HDL (“good”) cholesterol, and the ratio apoB/apoA-1. In addition, the medical food when used with the diet is almost twice as effective as one of the best diets alone for lowering risk factors for cardiovascular disease and is 40 percent more likely to resolve metabolic syndrome.

The medical food is effective in part because it activates selective kinase response modulator (SKRMs) at the cellular level. A kinase is an enzyme that translates dietary signals at the cellular level. It is like the conductor of an orchestra, sending cells the signals that direct them to function in a healthy way (producing harmony) or in an unhealthy way (producing discord).

SKRMs are nutritional substances that can work to modulate kinase signaling. SKRMs help to restore healthy cell signal transduction to genes, favorably affect gene expression, and help to reverse the effects of chronic illness. Bioactive plant compounds can function as SKRMs, having the ability to affect cellular signals that impact the underlying cause of many chronic illnesses. They can improve physiological functions and signal health through their communication to cells.²¹

The role of the SKRM explains how the substances in the medical food may impact the genes in the cells to express either health or disease. The discovery of natural SKRMs is a fundamental contribution to the understanding of how phytonutrients can improve health and reduce chronic health conditions associated with metabolic disturbances and altered kinase signaling.

Researchers have tested the effect of phytonutrients on kinases, then looked at how they change cell functions, and then showed how consuming the phytonutrients improved people’s health, demonstrating how SKRMs from plant substances help to create health.²² SKRMs derived from hops and acacia have been successfully integrated into the medical food tested in the three-university clinical trial reported in the Journal of Clinical Lipidology. The result is the ability to reduce cardiovascular risk factors and resolve metabolic syndrome better than a low-glycemic, Mediterranean- style diet alone.

The effectiveness of the medical food and diet to reduce cardiovascular risk factors and reverse metabolic syndrome gives chiropractors and other healthcare practitioners safe and effective options to treat patients with metabolic syndrome.

Lifestyle medicine programs enable chiropractors to help patients reverse metabolic syndrome and — even avoid chronic illness — by treating the cause, not just the symptoms.

With today’s chiropractic professionals facing significant decline in revenues, lifestyle medicine programs provide them with a new revenue stream that expands their patient base beyond just common musculoskeletal disorders, as well as generate referrals from local physicians.

Chiropractors now have a new practice model, and the research documenting the healing power of phytonutrients validates the clinical approach that undergirds the practice of chiropractic care.

Mark A. Kaye, DC, is the director of Clinical Product Services at Metagenics Inc., a nutrigenomics and lifestyle medicine company dedicated to reducing chronic illness and improving health. He has been with Metagenics for 17 years engaging in a variety of educational responsibilities, including national and international speaking engagements, regional training programs, professional re-licensing seminars, R&D, and clinical and product research. He can be contacted through metagenics.com.

 

References

¹firstlinetherapy.com: a turnkey, therapeutic lifestyle change program.

²Zarich S, Luciano C, Hulford J, Abdullah A. Prevalence of metabolic syndrome in young patients with acute MI: does the Framingham Risk Score underestimate cardiovascular risk in this population? Diab Vasc Dis Res. 2006;3:103-107.

³McNeill AM, Rosamond WD, Girman CJ, et al. Prevalence of coronary heart disease and carotid arterial thickening in patients with the metabolic syndrome (The ARIC Study). Am J Cardiol. 2004;94:1249-1254.

⁴Bokura H, Yamaguchi S, Lijima K, Nagai A, Oguro H. Metabolic syndrome is associated with silent ischemic brain lesions. Stroke. 2008;39:1607-1609.

⁵Park K, Yasuda N, Toyonaga S, et al. Significant associations of metabolic syndrome and its components with silent lacunar infarction in middle aged subjects. J Neurol Neurosurg Psychiatry. 2008;79:719-721.

⁶Brunt EM. Pathology of nonalcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol. 2010;7:195-203.

⁷Grundmark B, Garmo H, Loda M, et al. The metabolic syndrome and the risk of prostate cancer under competing risks of death from other causes. Cancer Epidemiol Biomarkers Prev. 2010;19:2088-2096.

⁸Hong SN, Kim JH, Choe WH, et al. Prevalence and risk of colorectal neoplasms in asymptomatic, average-risk screenees 40 to 49 years of age. Gastrointest Endosc. 2010;72(3):480-489.

⁹Pelucchi C, Negri E, Talamini R, et al. Metabolic syndrome is associated with colorectal cancer in men. Eur J Cancer. 2010;46:1866-1872.

¹⁰Shen Z, Wang S, Ye Y, et al. Clinical study on the correlation between metabolic syndrome and colorectal carcinoma. ANZ J Surg. 2010;80:331-336.

¹¹Setji TL, Brown AJ. Polycystic ovary syndrome: diagnosis and treatment. Am J Med. 2007;120:128-132.

¹²Bhattacharya SM. Prevalence of metabolic syndrome in women with polycystic ovary syndrome, using two proposed definitions. Gynecol Endocrinol. 2010;26:516-520.

¹³Borges R, Temido P, Sousa L, et al. Metabolic syndrome and sexual (dys)function. J Sex Med. 2009;6:2958-2975.

¹⁴Fraile JM, Torres RJ, de Miguel ME, et al. Metabolic syndrome characteristics in gout patients. Nucleosides Nucleotides Nucleic Acids. 2010;29:325-329.

¹⁵See LC, Kuo CF, Chuang FH, et al. Serum uric acid is independently associated with metabolic syndrome in subjects with and without a low estimated glomerular filtration rate. J Rheumatol. 2009;36:1691-1698.

¹⁶Sun F, Tao Q, Zhan S. Metabolic syndrome and the development of chronic kidney disease among 118,924 non-diabetic Taiwanese in a retrospective cohort. Nephrology (Carlton). 2010;15:84-92.

¹⁷Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003–2006. National health statistics reports; no 13. Hyattsville, MD: National Center for Health Statistics. 2009.

¹⁸Ervin R. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003-2006: National Center for Health Statistics, 2009.

¹⁹Fernandez ML, Jones JJ, Ackerman D, et al. A Mediterranean-style low-glycemic-load diet improves variables of metabolic syndrome in women, and addition of a phytochemical-rich medical food enhances benefits on lipoprotein metabolism. J Clin Lipid. 2011;5(3):188-196. (lipidjournal.com/article/S1933-2874(11)00082-1/abstract)

²⁰Metagenics’ UltraMeal PLUS 360° medical food.

²¹These findings have been published in peer reviewed scientific journals, including: Metabolic Syndrome and Related Disorders 2009, Inflammation Research 2009, and Nutrition & Metabolism 2008. (nutritionandmetabolism.com/content/5/1/29)

²²Research conducted by Metagenics Inc., a nutrigenomics and lifestyle medicine company dedicated to reducing chronic illness and improving health.