my family doctor by my conventional training and i'm also an integrative doctor so i practice functional medicine ok which sort of bridges the worlds of holistic medicine and conventional medicine well this is a good segue into what do you do exactly ok so functional medicine is i love it it's very scientific based but it's a medicine that was founded by my mentor by the movement what we believe is that well that basically we believe in biochemical individuality that every person is different and so they should be treated the same it shouldn't be such a thing as cookbook medicine we believe that we should be treating the person that has the condition not the disease specific recipe so we look at a person and try to see what other things are you know do a more physiologic approach to the underpinnings of the disease and we believe that there's sort of internal and external factor so like the c d c told us that for most conditions health conditions it's thirty percent genes and seventy percent lifestyle so you have to look at people individually and say how is your lifestyle affecting this condition and you know a lot of things that we know right now are that inflammation is a big foundation to a lot of illnesses cardiovascular disease osteoporosis and many of the other chronic diseases and if you look at what the sources of inflammation in a person's life might be maybe you could prevent all of those diseases and not just give them a staton drug for high cholesterol so those are the basic tenants of prevention that we're trying to look at the root of the what's the cause of the disease and see if we can help nutritionally with lifestyle and pharmaceutical management if we need to so in other words you know a functional medicine is getting is is hopefully getting to the individual prior to the onset of the disease or it can affect obviously you're saying after the disease also is diagnosed yeah it's a it's more of a systems biology approach to both prevention and to management of mostly chronic disease because in the current model of health care and no one is addressing chronic disease you know in surgery really works well for acute disease and pharmaceutical management i think works well for short term and should be short term give us for the viewers give some examples of chronic disease so that they understand what you're talking about chronic diseases are things that are long lasting the people have for a long time like osteoporosis  heart disease as my rheumatoid arthritis multiple sclerosis you know things that have a have a progressive unless you intervene a progressive trajectory  bad health with usually bad outcomes and so those those diseases you're suggesting obviously thirty percent genetics seventy percent environment as a right i mean there are diseases we know that women who have the bra genes have a higher incidence of breast cancer that's a different type of genes but for most of us the genome ics of this very small changes on our genes that make you you and me me  are thirty percent of what goes on but your lifestyle sort of washes over those genes and turns them on or turns them off so you can have a very high genetic risk for cholesterol for high cholesterol and heart disease in your family but if you eat a very low saturated fat diet you don't have that high cholesterol so it's your lifestyle that determines how your genes are turned on or off for most conditions and so how did your a family doctor when did you when did you stir start getting interested in functional medicine probably always in the not that it existed then but my background i was a teacher first actually it's interesting my father wanted to me to play the organ in a roller skating rink that was his dream career for me so i grew up in a time when i didn't really have the confidence to you know to know i could be a scientist so i was a teacher first but i got into environmental education and that's where i really understood this is jim's biology i started to look at the web of life and that really resonated with my values and the way i saw the world so with that i wanted to do more environmental work i got another degree in chemistry to incorporate the sciences and then somehow got to medical school it was never on my list of things to do but i just got attracted to the idea of being able to combine all of that and medical school was difficult when you went it's very black and white there and it was never very black and white in my mind and of course i was older when i went to medical school so i had to look at it in a different way and when i got out of medical school i was in the holistic medical students organisation and then i began to look into this other way of doing it this integrative approach and i got my master's in public health and studied women's health mostly and that's what i do more of although i have men in my practice too but women for the most part are interested more in prevention obtaining good health men i don't think they've been accustomed to that idea yet did you guys hear that they were like they're into the quick fix a lot you know and but the men in my practice are very prevention oriented and very interested in how to maintain a healthy lifestyle and how to not get the chronic diseases that they see in their friends relatives and family so then who would you say is primarily do you see people who already have chronic disease and are looking for alternative answers or do you see people who are healthy and hoping to remain that way both both y and so when so then if i if i understand it and you know i have labor's hereditary out there neuropathy i have not seen you but i would like to if i came to you see there is  at this point there is no treatment or cure for the genetic disease that i have and it is the only thing that it affects is the optic nerve but say a patient comes to you and has recently been diagnosed with m or one of the other chronic diseases and you're going to look at that individual patient and then you will do what you will do an evaluation based on their their body their lifestyle what what do you do then at that point we do a little bit of everything so i think the first thing is to get a good assessment of how they live their life so we'll talk about that to some extent but i like data i'm a scientist and i data so my job is to make the function of their life as healthy as they can as i can even if i don't know the name of their particular disease so i'm i just am looking for what are the imbalances in their life so we can do tests blood tests urine tests and stool tests and saliva tests that look at function so for example i want to know the function of your colonoscopy i want to know what the good bacteria is in there what the bad bacteria is in there because it tells me a lot about your immune system i want to know how your diet is being what your diet is but also if it's coming into your body if it's being digested properly if it's coming into the blood if it's getting into the cells if the cells are utilizing it correctly and if they're dumping the right by products into the urine then i might be able to say you know what you need more magnesium than most people you need more b twelve you you have a condition that means that you need more than other people so just taking a blood level of b twelve doesn't tell me if the b twelve is working for you were if you need more than other people that's fascinating right that's so if you optimize the person spawn ssion then maybe you're going to impact the particular condition that they're inquiring about just because you've improved or made reserve of their other function their other tissue function what is what so i have to ask what is your opinion on how much does nutrition affect most people most diseases i did when i was doing my public health degree i worked with oh i won't say her name but i worked with a doctor she turned around and she said to me do you really believe you are what you eat and i was shocked that a doctor when he asked you you know if you eat too much you get very heavy and if you don't eat at all you die so obviously you are what you eat and the interesting thing about you know we used to talk about calories fat and protein and carbohydrates as being the most important aspect of how you eat but what we know now is that food is information to your genes and the information to your genes is appropriate more so when you're eating natural food when you're eating the green food in the red food and they are in shoot and not the cheetos not those are so that when you're reading the packaged food you know it's not sending appropriate messages to your d n a when you're eating high fructose corn syrup you know that's laced with mercury now we find out you know that is not giving the appropriate messages to your genes my mentor this d jeff bland who's just amazing calls these things new to nature molecules and i think that's just a great great word you know we evolved with the plants and we evolve with the sun you know and so he says that the the largest randomised control clinical trial that's ever been done is is evolution that's where we've tested out what's good for us what's bad for us and over time we have evolved to eat the right plants and and be out in the sun and that's what our physiology is meant to to function how it's meant to function well and in the last hundred years when things like this packaged food has been developed and we're sitting in offices all day under fluorescent light we're in our physiology has been changed so radically in such a short period of time we think that this chronic diseases because we can't adapt that what say carbohydrates versus proteins versus fats how how do you think ideally nutrition should look so that d n a is optimally functioning in our bodies well you know i think that the guidelines are are good on that i think we should be actually probably a little less than thirty percent fat in our diet but probably people aren't eating as high a quality protein as they should and then of course you know we have the grain fed meets that are much better i'm sorry the grain fed needs that are a problem the grass fed needs which are much better for you so even when you talk about the different macronutrients like protein carbohydrates fat there's distinctions the distinction i was trying to make is that it's not just the type of food it's the quality of the food so within every type of food you're really looking for the most natural organic grass fed food you can get within all those categories i hate to do this because this is fascinating we're going to have to take a break and we'll be right back in just a couple seconds thank you ladies we'll be right back  well ok so if you're going to if you want to know more about you know what the appropriate diet maybe for you would be one of the things that we would do in our  office is run body composition analysis for you so we would run this bio impedance we would put you on that to on a massage table and almost like getting an e k g run a current through you which which runs a different speeds whether it's will concentrate more on resistance exercise and protein for you if you have too much fat we'll do the same trying to convert the fat to muscle because that's the objective like the body mass index thing body mass index is doesn't give you the compartments it does tell you if you're the appropriate weight for the height but we're interested in the compartments in the even the more fascinating part about this test is that we can look at the water in your body we can look at the water inside your cells and outside your cells so what you want is you want healthy cells to be like juicy plump like a grape hydrated hydrated you don't want them to be you know like a reason and you don't want a lot of water outside your cells or you'll be pu know and so is it can i interrupt you just for a second is this why and this is going to seem like a silly question but truly then if people are healthy on the inside their skin will always look better is that true i think that's true  know we have a picture in our office two you have two different people who have the same exact weight same exact height and it's sort of the picture breaks down what their insides look like depending on what they're eating so you can look good on the outside and some of that is genetic and some of that is just calories but on the inside you could be very unhealthy if those calories are coming from you know five bananas or three cheetos a day versus green leafy eason and more other better fruits and vegetables and lots of fire burn grass fed protein is the converse also true that you can have maybe breakouts but be pretty doing pretty well on the inside as far as the balance and you know i mean i think we'll skip the skin really is a good mirror of your health and i and so there probably is some imbalance if there's if there's a breakout in the body on the face of the skin then there probably is an imbalance that needs to be forward in media in case you might find this funny but if i have an event to go to three or four days prior to the event if i want to look extra special three or four days prior to the event i will have salmon blueberries really loves the omega the good omega fats and the good antioxidants and that's what you know we've been taught but i think actually to your point originally now that i think about it there is another imbalance which is your emotional spiritual mental physical and balance so you can be physically healthy and still have be having an emotional you know crisis or be too stressed out or very talking  right and i liked what you said earlier about not looking at the disease itself but looking at the symptoms and how the person is doing and that holistic approach very good approach whether it's physiological medical psychological emotional mental health do you know kate that i was recently about a month ago i was recently interviewed by a reporter and he did an article he specifically wanted to speak to one of the physicians that actually the first physician that diagnosed me with labors and he asked them the question i i i am pretty indignant that nutrition has a lot to do with aging any disease that we have so obviously i said this to this reporter question this doctor and the doctor had a quote he quoted him in the article and the doctor said specifically that no nutrition had nothing to do with any of my recovery of my site so there are many physicians out there that do not believe nutrition has anything to do with them obviously you can tell i have an issue with you know i i know people have different philosophies you know and everybody's entitled to their philosophy but actually we had a therapist in my residency program who said don't worry you'll get the patients you deserve so the truth is you're attracted to who is going to be on your same wavelength in terms of your values and your belief systems and you know people who come to me are already pre selected there and they've been to my website they know what i'm about they come pre selected they're ready for the kind of thing that i want to talk about and do for them help them with and collaboratively collaboratively we do that but people who go to other doctors who don't believe in nutrition and hand out antibiotics and all that's another way of doing it that's just fine you know and that their prognosis is also contingent on motivation so they're highly motivated by the time they get to you  they sort you out they're looking for a very particular type of treatment or intervention and they wind up on your doorstep and there they don't make sebastian yeah it makes it much easier not to convince anybody you know so i think doesn't physician i think it did at some point i read that it actually meant in greek educator you know it's not healer you know really you're just a purveyor of information for people so that people can make their own judgments about how to lead a healthy life or you know or we are also the keepers of the prescriptions you know so we do we do have that that we can do or the surgeries or something but really we're supposed to be about educating people to make choices for themselves so that they can prevent diseases you know and they can live a happy healthy life or they can you know make choices about their disease management  you think ok that there's been a paradigm shift lately maybe the past twenty years about medicine in terms of medicine you're saying that maybe the new perspective is to  have a holistic and comprehensive approach to treatment and also preventive medicine compared to when our parents were growing up and they went to the doctor for that pill or that shot so it's a very different mindset do you feel that there's been that kind of a shift and looking at our health and the way that we treat ourselves as well i think it's definitely calming and i think it's being driven by the consumer who knows that health is more than just taking a pill or having a surgery and and knows that chronic diseases is on the rise and they see you know cancer is everywhere so people are trying to take an active role so they're the ones that are driving it you know medicine is you know conventional medicine is having a little more collaboration with physical medicines like physical therapy and car practic you know and and collaboration with each other but there's also this other movement that i'm in that i think is also growing in popularity which is changing the whole thing change it all you know let's really focus not on disease management but it's not that profitable you know the profits are in doing surgeries and selling pharmaceuticals and and so prevention doesn't get a lot of reimbursement that's right i can't write you know that the person came into my office i can't write a code for i want to prevent these diseases and have it get paid for by the insurance company and yet that would be the cheapest way to do medicine in the long run you know so it's an ongoing progression but i think we are moving in that direction it's a very exciting time to be in this profession medicine and mental health you have a more educated  patient a more educated consumer so it's it's nice it's nice to work with that i have a question how do you deal with when there's a conflict of interest or when you're working with a patient who also sees another type of physician and you have to work collaboratively how do you reconcile yourself with those types of conflicts that we just talked about him you know unfortunately it would be a really nice world if we could all just get on the phone and talk to each other or email each other and say you know this and that and this is what i'm doing this what you're doing but time being what it is everybody is really very very busy so you know i will provide the patient with all the materials that i think that they need that they can talk to their physician about but ultimately it's that it's the patient who has to decide and it may be just a belief system it may be that if they're more interested in that mean i don't really believe in a whole lot of right and wrongs you know i mean if their belief system is more geared to the way i'm practicing medicine with them then they're likely to get better doing what we're doing together versus you know i always tell people if it's going to make you anxious to take the pill every morning and say i really don't like this i really don't want this it's really not doing you any good you know regardless of what the physiology is i don't think you can have that conflict so you've got to do what you think i mean i think we moved away from using our intuition and saying i feel better when i do things that are in my value system in my belief system  this is absolutely killing me to do but we are at the end of our show this was extremely interesting especially for me so thank you ladies thank you  you'll come back and visit again i'm sure and if anybody would like to know more about the show or would like to see other topics please email me at studio b health dot com thank you very much we'll see you