Physicians can leverage language around exercise to lower patients' risks and achieve weight loss goals. Here is how.
Shilpa P. Saxena, MD, IFMCP | May 16, 2022
Mitochondrial dysfunction is associated with the development of some of the most common cardiac conditions we manage—atherosclerosis, ischemia-reperfusion injury, hypertension, diabetes, cardiac hypertrophy, heart failure and arrhythmia.
Shilpa P. Saxena, MD, IFMCP | February 28, 2022
If you talk to non-clinicians in the health care industry, you might not be surprised to find they are unimpressed with the average clinician’s understanding of business philosophy. Who would blame us clinicians? We focus on patient care, and the most...
Shilpa P. Saxena, MD, IFMCP | February 14, 2022
Fads come and go in the health and wellness space. When it comes to fasting, expect this one to stick around for the long-term. Unlike harmful diuretic weight loss pills, cabbage juice dieting, or the Thigh Master, fasting comes in many forms to fit the unique needs of the patient. These include fasting mimicking diets, intermittent fasting, weekly 24-hour fasts, alternate day fasting and more aggressive, extended fasts that require medical supervision.
Steven Imgrund, MS, CNS | July 16, 2021
If someone asked one of your new patients (between three to six months of care) how their care has been progressing, what would they say? Would they be able to talk about their subjective improvements, like energy levels, and how those relate to improvements in other categories, such as body composition goals, inflammatory markers, lipid levels and common diabetic parameters?
Steven Imgrund, MS, CNS | March 16, 2021
As a functional integrative medicine practitioner, you know all about homocysteine, and how this non-essential amino acid is connected to methylation and a common genetic mutation of the MTHFR SNP. Methylenetetrahydrofolate reductase (MTHFR) is the rate-limiting enzyme in the methyl cycle, and it is encoded by the MTHFR gene. Methylenetetrahydrofolate reductase catalyzes the conversion of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate, a co-substrate for homocysteine remethylation to methionine.
Steven Imgrund, MS, CNS | October 16, 2020
In functional medicine, we are in no short supply of tests. Given the opportunity, many clinicians would love nothing more than to run copious amounts of blood, saliva, urine, and stool samples to assess every aspect of their patients' health. But the issue is that the cost of testing alone could reach thousands of dollars, and at that price, you better have a good reason why each test was chosen and how each will lead to better treatment.
Steven Imgrund, MS, CNS | June 16, 2020
The triumph of health care will hinge on health professionals reinventing the way in which we work with a patient, with a population, and often overlooked, with each other. We have seen how large conventional multi-disciplinary models are challenged getting to know one patient; conversely, we can admit it is equally challenging for one provider to have all the knowledge needed to provide total care to any one patient or population.
Shilpa P. Saxena, MD, IFMCP | March 16, 2020
The American Academy of Family Physicians asserts that group visits are an effective method for enhancing patients' self-care of chronic conditions, increasing patient satisfaction, and improving outcomes. Group visits (AKA shared medical appointments) occur when multiple patients are seen in a group setting for follow-up care or management of chronic conditions (e.g., diabetes group visit). A lifestyle-based group visit, furthermore, incorporates the power of functional and lifestyle medicine into this innovative appointment format.
Shilpa P. Saxena, MD, IFMCP | September 16, 2019
Let's face the facts: If you see human patients, you're seeing patients with metabolic dysfunction. Even children, who should be resilient and thriving, are showing signs of metabolic dysfunction. Think back to the average patient walking through your doors (or on your virtual appointment calendar). It's rare to not see at least one or two aspects of metabolic syndrome.
Steven Imgrund, MS, CNS | March 16, 2018
In 2021, we are in no short supply of supplements that can support healthy cholesterol and improve lipid measurements. Many are backed by stacks of research including mechanistic studies, human randomized controlled trials, and some even have thousands of years of historical use in Ayurvedic and Traditional Chinese Medicine. It seems a lack of options is not the issue here. Rather, many clinicians are reluctant to or frustrated with incorporating supplements into a treatment plan, especially when it contradicts current guidelines.
Steven Imgrund, MS, CNS | January 16, 2018
There has never been a better time for functional medicine.The population of the modern world has a weight around its ankle named chronic disease, and we have been walking the pandemic plank for the better part of 2020.As a health care practitioner with an abundance of passion and sharp clinical knowledge, you see the writing on the wall. You know your patients need a personalized functional medicine plan with a foundation of lifestyle medicine.Knowing this and attracting actual patients to your practice are two separate things, however. Unfortunately, this hurdle often leaves many providers at the starting line stuck in pre-contemplation.
Steven Imgrund, MS, CNS | November 16, 2017
While I enjoy writing technical posts, my passion lives with sharing patient stories as clinical education. In our provider world, we call these "case studies," but to me, it's so sterile-sounding. These are real people-parents, siblings, children-unique individuals who all have a life they literally hand to us so it can be optimized and juiced for everything it's worth. So, without further ado, I introduce you to Ken!
Shilpa P. Saxena, MD, IFMCP | August 16, 2017
The coronavirus has skyrocketed the demand for health care while simultaneously amputating its main arm of delivering the care itself. People desperately want to see trained professionals; however, they are equally afraid to see them in-person. And because face-to-face individual appointments had been the comfortable and seemingly secure way of seeing patients pre-COVID-19, many smaller medical offices are suddenly disoriented and struggling to figure out how to pivot to remain solvent these days.
Shilpa P. Saxena, MD, IFMCP | April 16, 2017
A recent publication in PeerJ documented compelling evidence that exercise might not be the key to controlling body weight.
Jonathan Cannizzo, MSc | March 22, 2017
Heart disease is still the most significant mortality threat to Americans today. But now, cardiometabolic experts are asking this epigenetic question: How will the dramatic COVID-19-related changes to our daily lifestyles affect our patients' risks for cardiovascular disease?
Shilpa P. Saxena, MD, IFMCP | November 16, 2016
On April 16, 2020, the Personalized Lifestyle Medicine Institute, in collaboration with Ortho Molecular Products, convened more than 4,600 healthcare practitioners to Simplexity Medicine: Health Care Reimagined. The virtual, live conference was a silver lining amid all the uncertainty surrounding COVID-19, an opportunity for functional medicine practitioners to connect and learn from a faculty of experts sharing their insight on the virus and its effects. Attendees also learned about ways to transition their practices to a virtual model using the Virtual Practice Pivot Program.
Olivia Morrissey | October 16, 2016
There has been a lot of buzz around "bioavailability" lately, especially as it concerns dietary supplement ingredients like fish oil, CoQ10, and phytonutrients like curcumin and resveratrol. However, much of what is marketed as having increased bioavailability rarely translates into meaningful therapeutic improvements, especially when it comes to phytonutrients.? This is primarily because phytonutrient research has mostly followed the same path used for developing drugs, which focuses on single compounds discovered through in vitro activity screening methods.
Thomas G. Guilliams, PhD | July 16, 2016
Group medical visits, also called shared medical appointments, are provider-patient medical encounters in which a group of people are seen together in a concurrent session. Although the individual face-to-face appointment continues to be the prevailing model of patient care, by default mostly, there is growing evidence that suggests group visits are indeed effective, and furthermore, provide benefits above and beyond an individual encounter.
Shilpa P. Saxena, MD, IFMCP | May 16, 2016
Statins have been the cornerstone of heart disease prevention in the conventional medical model for a long time. However, there is a growing resistance to using this prescription among patients. More and more, our culture is questioning the slippery use of pharmaceuticals as the panacea for the complex, chronic disease epidemics of our time, and statins are at the forefront of this shift.
Shilpa P. Saxena, MD, IFMCP | December 16, 2015
When I first began my foray into functional medicine, I was pleasantly surprised to hear of this thing called functional foods. As someone who doesn't like to eat solids for breakfast, who loves the concept of eating but feels it gets in the way of more pressing matters, and who surely needs some daily nutrient therapy for existing and future medical issues, I found functional foods deserved that heavenly operatic "Ahhhhhh" when I began enjoying all the benefits they provided me in my day-to-day life.
Shilpa P. Saxena, MD, IFMCP | November 16, 2014
While the ketogenic diet (KetoDiet) may have had its roots as a treatment modality for epilepsy as far back as the 1920s, variations of this diet are now mostly popular for their metabolic outcomes (e.g., weight loss, improved glycemic control, etc.) or for cognitive support/neurological conditions (e.g., Alzheimer's disease, malignant glioma, migraine headache, and other neurologic disorders).
Thomas G. Guilliams, PhD | May 16, 2014
As scientists continue to find evidence that interfering with vitamin K may have unintended effects like vascular calcification, they also hope to research how calcification can be prevented.
Jeffrey Bland, PhD, FACN, CNS | January 16, 2014
When the body uses vitamin K in blood clotting, the vitamin K is recycled through a redox reaction. Warfarin prevents clotting by blocking the recycling enzyme in this reaction. But this inhibition of vitamin K in the vasculature by warfarin may be detrimental.
Jeffrey Bland, PhD, FACN, CNS | December 16, 2013
Vitamins have captured the attention of health-conscious people ever since the term "vitamin" was coined in 1912. Named "vita" for life or life-giving and "amin" for amine compounds, scientists now know much more about these crucial dietary components, including the fact that not all vitamins contain amine groups. There is still more to learn about how vitamin intake from our diets prevents or causes disease, or how diseases may cause vitamin deficiencies. But some experts are raising a new concern: that the common drug warfarin is actually contributing to disease by interfering with vitamin K.
Jeffrey Bland, PhD, FACN, CNS | November 16, 2013
If you talk to non-clinicians in the health care industry, you may not be surprised to find they are not overly impressed with the average clinician's understanding of business philosophy. Who would blame us clinicians? We focus on patient care, and the most important thing we may learn about the "business" of conventional medicine is how to optimize billing and coding.
Shilpa P. Saxena, MD, IFMCP | October 16, 2013
Let's face it. Advising patients to exercise and engage in regular physical activity is a prescriptive no-brainer. The case for movement as medicine continues to solidify as journal after journal elucidates the anti-inflammatory powerhouse that exercise is. Whether for the reduction or reversal of obvious cardiometabolic diseases like diabetes and heart disease or of lesser-known chronic complex conditions like autoimmunity, cancer and dementia, exercise should be a foundational strategy to reduce inflammation and change epigenetic signaling for a healthier future for all patients.
Shilpa P. Saxena, MD, IFMCP | December 16, 2012
Cardiometabolic disease is rampant in the United States and our current approach to treating it is broken. For years, doctors and patients have been taught that cholesterol is the underlying cause of heart disease. The American Heart Association has recommended a low-fat, low-cholesterol diet based on the guidelines of the USDA food pyramid. Unfortunately, following this pathway has led to increased obesity and diabetes, thanks to a calorie intake of mostly sugar and high glycemic carbohydrates.
Todd R. LePine, MD | September 16, 2012
Mapping the Cardiometabolic Patient JourneyAs of 2015, the combined prevalence of diabetes and prediabetes was 45.4% among adults in the United States. Approximately 11% have diabetes and 33.9% have prediabetes, representing 84.1 million people who could develop type 2 diabetes within five years, according to the CDC in the 2017 National Diabetes Statistics Report.Read more
Shilpa P. Saxena, MD, IFMCP | July 16, 2012
A New Pleiotropic PathFrom early ideas about dietary fat, to a complex array of genetic risk factors and biomarkers, the arc of scientific discovery is pointing to cardiovascular disease being a pleiotropic condition. It follows, then, that one agent against a cluster of diseases will not produce favorable outcomes. The old "a pill for an ill" model will be outdated.Read more
Jeffrey Bland, PhD, FACN, CNS | June 16, 2012
Vector of Truth: Medical Research is an Arc of DiscoveryAnyone who devotes their career to scientific research is likely a seeker of truth. But this can sometimes mean taking the road less traveled. Even in medicine, it can be tempting to take the path of not seeking the hard and difficult questions about a disease, but to seek the expedient answers.Read more
Jeffrey Bland, PhD, FACN, CNS | May 16, 2012
Functional medicine can sometimes clash with the broader healthcare industry, which focuses on treating specific systems or diseases. In functional medicine, practitioners offer a more holistic and preventative approach to care, often recommending lifestyle, diet, and nutritional supplements. However, the norms of pharmaceutical research don't necessarily translate into effective supplement research. Moreover, nutritional supplements often fall into gray areas in drug regulation, making the safe and effective use of supplements difficult for many functional medicine clinicians.Read more
Jeffrey Bland, PhD, FACN, CNS | April 16, 2012
The Gym Inside Your Door program was initially developed to increase daily physical activity in prediabetic and diabetic Alaska Natives in 2007, but has since gained widespread use in primary and secondary prevention programs. Diverse forms of physical activity have been shown to improve health outcomes and reduce risk for cardiometabolic disease. One means of prescribing exercise is by recommending specific physical activities by their frequency, duration and relative intensity. Read more
Ralph LaForge, MSc, FNLA, CLS | March 16, 2012
Do you talk about the importance of nutrition and prescribe a personalized diet to every patient, regardless of health status, who walks into your clinic? Of course, you do. Every functional medicine clinician understands the importance of nutrition. What you eat matters. It plays a role in your long-term health, wellness and ability to prevent chronic disease. No one would argue that. Now, let me ask you this: Do you talk about the importance of physical activity and prescribe a personalized exercise program to every patient, regardless of health status, who walks into your clinic? Read more
Jonathan Cannizzo, MSc | February 16, 2012
This post correlates to a presentation delivered by Dr. Gladd at The Evolution of Cardiology Functional Forum (March 2017). Click here to view the presentation.
Jeffery Gladd, MD | November 16, 2011
Cardiovascular and cardiometabolic disease continue to devastate the lives of patients, families, communities and the US healthcare system at large. The sad truth is, a solution already exists. If healthcare systems could figure out how to implement therapeutic lifestyle change, nearly 80% of the world's medical problems would either be prevented or reversed. Over the last 10 years, I have seen this solution play out in my office and other Functional and Integrative offices around the world. So, why isn't this already happening? Three things: 1) Provider training, 2) Patient engagement, and 3) Cost. Read more
Shilpa P. Saxena, MD, IFMCP | July 16, 2011
The statement, "Exercise is an important part of lifestyle medicine," seems rather obvious. Studies indicate relative risks for cardiovascular disease are up to three times higher for inactive persons as compared to active. In fact, physical inactivity is as harmful as other conventional risk factors, such as blood pressure and cholesterol levels, in predicting chronic disease. Yet, only 10% of Americans meet the recommended level of 150 minutes of exercise per week. Read more
Jonathan Cannizzo, MSc | March 16, 2011
I get this question a lot when speaking to practitioners about starting their own micropractice, "Why would patients pay me?"Do you wonder how someone would pay cash for your services? Do you think you need to offer fancy testing and really involved therapies in a high-end office space?In my opinion, it is difficult to successfully run a medical practice dedicated to health promotion and take insurance. A direct-pay practice that lives outside of the squeeze and time crunch of insurance will have you loving work and enjoying your life. Many find this daunting, but realize the rewards, not all of them financial, are great. I find picking my kids up from school a couple days a week rewarding. I find three-day weekends rewarding as well. Read more
Jeffery Gladd, MD | October 16, 2010
Statistics continue to highlight the snowballing burden of complex, chronic disease as the 'Achilles heel' of our healthcare system's future. More and more healthcare providers are realizing that the most effective solution is centered around lifestyle change and behavior modification. Unfortunately, implementation of successful lifestyle modification amongst a population of patients overseen by trained clinicians in supportive institutions has been problematic in the typical medical office, to say the least. Fortunately, a progressive form of relief called lifestyle-based group visits (LBGV) is positioned to rescue the time-starved, well-intentioned clinician. Read more
Shilpa P. Saxena, MD, IFMCP | August 16, 2010
Exercise is like eating: Patients think they are doing a lot better at it than they actually are. They may head to the gym after a long workday or commit to going for a run each morning, but the road to an unhealthy lifestyle is paved with good intentions. Hurdles to achieving healthy exercise habits are real, but they can be overcome with the right knowledge and diligence. Read more
Murray Ardies, PhD | July 16, 2010
Do you prescribe regular exercise for your patients with metabolic diseases? Of course you do. You want the best health outcomes for your patients and you know that regular exercise can be a remarkably effective intervention for the prevention and treatment of numerous cardiometabolic diseases and weight management issues. But do you know how much exercise is required to induce metabolic benefits? Even more importantly, do your patients adhere to your exercise prescription? Read more
Sean Newsom, PhD | April 16, 2010