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FoundationMED is so named because we feel that the key to health and vitality is a strong metabolic foundation. We believe that core clinical 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. In addition, we must monitor metabolic markers that indicate movement away from optimized health and wellness.

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
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    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.

    Michael Pollan, in his book "In Defense of Food" outlines a very good approach to health enhancing nutrition - essentially eating actual food (as opposed to food-like substances that are the primary source of calories for a significant portion of our population). This is a very good read, and on our recommended list in the library.

    In addition, I hope that you also read "Why We Get Fat: And What To Do About It" by Gary Taubes. This book outlines the basis of increasing your weight/fat (hint- it is not simply that you eat too much and don't exercise - also alluded to as being gluttonous and slothful). It is, in fact, this basic misunderstanding that leads ultimately to so many failures when it comes to tackling obesity.

    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
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    "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 as known as aerobic exercise and anaerobic exercise, as well as weight bearing exercise and stretching.

    It can be quite easy 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 exercise that works for you.

    Remember, the number one killer in this country remains 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.

    What typical exercise will not do is to help you lose weight. Get over it! A recent study (Friedenreich CM, et al. Adiposity changes after a 1-year aerobic exercise intervention among postmenopausal women: a randomized controlled trial. Int J Obes (Lond). 2010 Sep 7. [Epub ahead of print]) demonstrated that it took about 77 hours to lose a kilogram of fat.

    77 hours… 1 kg of fat… not all that effective - no?

    You cannot exercise your weight off while eating inappropriately - and that does not mean calories. Weight loss/gain is not simply a matter of eating too many calories and not exercising sufficiently (gluttony and sloth). In fact, this myth is doing great harm to the general public insofar as it diverts attention from the real problems with weight management and how it integrates with basic wellness. For more information on this fascinating subject, I recommend you read "Why We Get Fat: And What To Do About It" by Gary Taubes. A fascinating read!

    While I am at it, I must mention how much I enjoy Rodney Yee videos (DVDs) for moving yoga/stretch. His video routines are very easy to follow along with and, with consistent practice, cannot help but make you feel fantastic. It can be amazing how much better you feel once you have stretched. His videos are available on Amazon, and he has a website as well.

    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
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    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" tab (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.

    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. For example, 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.
  • 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. Often times this deterioration proceeds undetected and under the radar of the traditional medical approach.

    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 and you have a chronic illness.

    Foundational Medicine 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. It is vitally important to measure cholesterol particle counts, as well as degree of oxidation.

    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.

    Traditionally, pre-diabetes is considered to be present when the fasting glucose is between 100 and 125 mg/dL. From a functional point of view (and supported by research data) this is far to generous - with a fasting glucose of 99 much to high to be accepted as OK and not worthy of therapeutic intervention. In addition, additional information can be gleaned by also checking the fasting insulin level for a variety of reasons.

    FoundationMED uses a similar approach but with an eye towards root cause of disease. By paying keen attention to appropriate markers, we hope 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.

    In 2008, the American College of Endocrinologists and the American Association of Clinical Endocrinologists issued a consensus statement regarding the diagnosis and management of pre-diabetes. One of their key recommendations for changing the tide of type 2 diabetes stated: “Diagnostic tests should be developed to better distinguish patients who will progress to diabetes from those who will not.”

    I couldn't agree more

    . Appropriate laboratory data enables us to both identify high risk patients and follow them clinically to assess progress with treatment... Armed with this data, we work together using multiple techniques to get that score down to normal (thus markedly decreasing your risk of metabolic syndrome and diabetes).

    Other partners include SpectraCell Laboratories with their incredible Cardiometabolic Assay. Vitamin, mineral and antioxidant deficiencies have been shown to suppress immune function and contribute to chronic degenerative processes such as arthritis, cancer, Alzheimer’s, cardiovascular disease and diabetes. This body of research has been reaffirmed by the Journal of the American Medical Association (June 19, 2002-Vol 287, No 23). If needed, it can show key deficiencies that need to be addressed but can be very difficult to ascertain in any other fashion.

    Cyrex Labs, Precision Analytical, ZRT Labs, Genova Diagnostics, HDRI, Doctors Data and others are invaluable in providing information when needed to get to the core issue of your underlying dysfunction - including Metabolic problems, GI problems, Leaky Gut, SIBO, Gluten Sensitivity, Methylation issues and many more.

    While I am thrilled that such sources of valuable information exist, 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 - and unlike many other practices, we never up-charge our patients for lab tests. This means less expense for you.
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