General Wellness


 

FoundationMED is so named because we feel that the key to health and vitality is a strong physiologic foundation.

We believe that core physiologic imbalances underlie the expression of many disease states that we find ourselves in - particularly as we age.

These clinical imbalances form a pattern of dysfunction and are the result of mediators, antecedents, toxins and triggers.

The very best way to begin is to strengthen your core clinical foundation by means of proper nutrition, exercise and toxin avoidance - as well as proper sleep and stress management (ie "the 5 boxes"). In addition, we must monitor metabolic markers that indicate movement away from optimized health and wellness as well as properly assess and address underlying physiology.

We also believe that knowledge is power - particularly when it comes to enhancing your personal health foundation. To that end, we strive to make sure our patients are very well informed and up to date. In addition, our patients have remarkable access to our physicians for questions that may come up.

 

Nutrition

FoundationMED believes that the very essence of maximizing health begins with nutrition. That being said, "proper" nutrition can seem to have multiple meanings depending on your point of view. Although this may be true, we strive to seek the core truth (foundational?) as to what constitutes an appropriate approach to good nutrition. 

While we have listed below a few ideas to get you started, our patients will enjoy more information and shared ideas to make eating healthier more a part of everyday living!

Some fundamental diet principles include:

Real Foods - Ideally food with no labels (you know - fruits, vegetables, meats, fish). If there is a label, make sure it has fewer then 5 ingredients - but make sure you use some nuance with this (i.e. Cola is in no way an appropriate "food" even though it may have few ingredients).

Learning to read nutrition facts and ingredient lists - being aware that some ingredients are exempt while others are disguised. A great example is MSG and Glutamate - something to absolutely avoid as a food additive - check out http://www.msgtruth.org/. Glutamate is but one issue in processed food - there are others...

High-Fructose corn syrup lurks everywhere processed food hangs out, as well as many fast-food restaurants. Avoid it completely.

Watch the sugar load in all forms - even organic cane sugar. Avoid agave, white sugar, and so-called sugar substitutes such as Aspartame et al. Sucralose is to be shunned…

Refined anything is not for you. That includes refined flour, sugar, oils (corn, soy, etc). Enriched (as in enriched bread) is another danger signal - real food does not need to be enriched - this indicates processing that has removed natural healthful substances!

Do not consume anything with hydrogenated oils, or partially hydrogenated oil, or trans fats of any kind - . These too can lurk in foods you don't suspect. Remember, oils can change from helpful to harmful based on temperatures used. Oils have a temperature (and it varies) over which it can become a toxic fat.

Avoid all things artificial - sweeteners, preservatives, coloring, dyes, "natural flavorings", "flavor enhancers" (see MSG/Glutamate). Don't trust reassurance that these chemicals have no effects - no appropriate long-term studies have been done.

Be open to exploring beyond your comfort zone. There are many natural foods out there that you have not experienced. Perhaps you can begin to explore what the natural food world has to offer!

 

Exercise

"Movement is Good" - summarizes what is generally known - that a healthy lifestyle includes exercise and stretch. Note though that exercise is not a particularly useful way to actually lose weight - it is useful for other aspects of health and well-being.

What is needed is to come to appreciate exercise for what it is, and to do it regularly without dread. There are many types of exercise to enjoy and incorporate into your lifestyle. This includes what is known as aerobic exercise and anaerobic exercise, as well as weight-bearing exercise and stretching. Resistance exercise may be important if you are becoming too low in muscle mass (sarcopenia). FoundationMED monitors muscle mass in all of our patients using advanced InBody analysis with each visit for no additional cost.

It can be quite "do-able" to incorporate exercise into your daily routine - such as parking a little further away from your destination and walking, taking stairs, etc. What is important is that you actually do exercise and enjoy it so that you will do it regularly. This means finding an exercise that works for you.

Remember, the number one killer in this country remains the heart and vascular problems. It is the heart that benefits the most from exercise, although the entire body benefits - including bone health with weight-bearing exercise, as well as muscle mass so needed as we age to avoid muscle mass loss (sarcopenia). Exercise also has a major role in preventing Cardiometabolic Disease and decrease insulin resistance, as well as increase joint mobility and decrease joint pains.

Stretching regularly is also highly recommended and has some very solid research showing a plethora of benefit. Think of it as a free form of health-enhancing supplement!

Developing a lifestyle with more exercise can be done in a graduated manner. Although I enjoy working out at my local health club, that may not be for you. No problem! You can get good exercise with minimal or no equipment. What is important is that you recognize the need for making exercise a part of your routine.

 

Toxin Avoidance

While toxins and toxic exposure is a major subject in its own right, in the context of general wellness it is important to even recognize that we are commonly exposed to toxins that both affect the body, and require that the body detoxify and/or eliminate them else they accumulate and cause harm.

Underlying this is the fact that chronic diseases often begin with a "gene-environment" mismatch. Thus, genetics, environmental exposure, and unhealthy diet choices can affect how well you handle the toxins to which you are exposing yourself. As the toxic burden increases, the stage becomes set for toxicity symptoms and disease.

There are confounding issues and complications everywhere you look in relation to toxins, toxic exposures, and toxic burdens.

It is most important that you decrease your exposure to toxins as much as possible, beginning with your food and drink.

We discussed focusing on "real foods" under the "Nutrition" section (above). This helps with avoiding toxins commonly added to our food supply, but there are many more levels on which to be concerned.

For example, the plastics chart shows many common plastics that are, in fact, considered a source of toxin exposure - not the least of which is the ever-present polystyrene cup. Even worse, these cups hold hot beverages commonly, the heat known to make the toxins from the polystyrene even more available in the cup-o-joe that you might be enjoying - not to mention putting a polystyrene cup into the microwave to heat up your drink.

BPA (Bisphenol A) is in many plastics, even though Canada (and others) have declared it a toxic substance. Some, but not all, of the plastics type #3 and #7 will contain BPA. Suffice it to say that this substance is a known endocrine disruptor and must be avoided.

While there are many sources of toxic exposure, through knowledge and awareness we can work together to significantly decrease the load and, if necessary, enhance your ability to detoxify and eliminate toxins (for example by properly assessing and addressing methylation issues - intimately linked to your detoxification processes).

Under the moniker of toxins, I will also place toxic metabolic products that occur as a normal part of metabolism. Unfortunately, some individuals, for complex reasons - may accumulate these products and thus subject themselves to much-augmented risks of cancer and other maladies. As one of many examples, Estrogen in the body exists in 3 forms (E1, E2, E3), The breakdown of E1 and E2 can be abnormal in such a way as to allow toxic metabolites to build up. This is known to greatly increase cancer risk but is rarely monitored or treated by traditional physicians. I can assure you that this was not covered as a condition to follow/treat in medical school. By appropriate testing and treating if needed, it is relatively easy to correct the toxic accumulation of estrogen metabolites if it is found to be a problem.

Other areas of General Wellness that FoundationMED focuses on include proper Sleep and Sleep Dynamics, as well as Stress and Stress Management.

 

Disease Markers

In the vast majority of the time, disease does not just suddenly appear. There is a "slow build" as your underlying health and wellness deteriorate due to disturbed physiology and toxic influences. Often times this deterioration proceeds undetected and under the radar of the traditional medical approach until frank disease "suddenly appears".

Eventually, symptoms develop, at which time you may or may not seek medical care. Typically symptoms are treated to suppress them, even as the underlying root cause continues unabated. Eventually, full-blown disease demonstrates itself or you find that you have a chronic illness.

FoundationMED's approach is designed to subvert that insidious progression to disease by monitoring, through appropriate tests, underlying markers or indicators of pre-disease states.

A commonly considered example might be cholesterol levels. Although there is much controversy as to how cholesterol impacts the progression of vascular disease, it is a common marker to follow in traditional medicine. Once the level gets high enough, traditional physicians - using drugs such as Lipitor - try to lower the cholesterol to what is considered safe levels. Unfortunately, a simple cholesterol test is far from adequate and does not adequately reflect the underlying disturbed physiology. It is vitally important to measure cholesterol particle counts (LDLp), as well as the degree of oxidation - LpPLA2, oxLDL, and other scientifically validated risk markers (Lp(a), others).

Another example is assessing for pre-diabetes. Pre-diabetes is vitally important to detect and vigorously prevent from progressing. It is one of the fundamental issues found to be responsible for the development of chronic disease and accelerated aging.

Beyond simply monitoring fasting glucose for elevation (which can occur without insulin resistance), other markers to be monitored include fasting insulin, HbA1c, LP-IR, and dynamic post-meal glucose levels.

By paying keen attention to appropriate markers, FoundationMED hopes to get a jump on disease progression in our patients. Testing is always within the context of what is prudent and proper for any given patient's circumstance.

Appropriate laboratory data enables us to both identify high-risk patients and follow them clinically to assess progress with treatment

 

Laboratory Testing

FoundationMED utilizes both common test labs (ie LabCorp and Quest labs) as well as more esoteric labs and testing such as Cyrex, Doctors Data, Genova, GI-MAP, Great Plans, Opus 23, StrateGene, and others.

We take the time to fully understand the tests we are ordering (which can be quite complex) and how they relate to the underlying physiologic processes being tested, and further how to best address findings that occur. We do not solely depend on the brief test summary statements that are provided by most labs as a simplistic overview guide. We review in detail all testing that is obtained with our patients.

While I am thrilled that such sources of valuable information exist (testing laboratories), they are only used if absolutely needed in any given individual situation. Many times insurance will cover the expense of testing, but in all cases testing is only requested if felt to be absolutely necessary. Since we do not uncharge on testing as is done in most other offices, your costs are kept lower.