HealthCoach “Mens sana in corpore sano” (i.e., “A sound mind in a healthy body”) is possibly one of the phrases in human history with the widest range in meanings. Originally this phrase comes from Satire X of the Roman poet Juvenal (~60–127 AD). Juvenal’s intention with this phrase was rather to teach his fellow Roman citizens the
WEARABLES AND GLUCOSE MONITORING – HEALTHCOACH
More than 29 million people in the US have diabetes, a staggering one in four don’t know they suffer from it and K6 children are developing prediabetes at alarming rates.
For those who do, how you regularly track glucose data depends on the type of diabetes one has and the treatment required. Monitoring is commonly done by taking a drop of blood with a pinprick, but a lot of people track continuously with wearables that measure blood sugar at intervals and relay that information to a smartphone or other device. (HealthCoach)
The first option is unpleasant and often inconvenient; the second is costly, and still invasive – but there is hope for diabetics to live more comfortable lives in the future with continuous glucose monitoring.
Non-invasive testing, where the skin isn’t penetrated at all, is the key to glucose monitoring.
Dexcom is one of the biggest names in continuous glucose monitoring with devices used by 200,000 people worldwide. Dexcom’s wearable tracker is made of two parts: a disposable needle that goes just under the skin to monitor interstitial fluid; and a patch that sits on top, housing the electronics that measure the sensor and transmit them to a Bluetooth device.
Most continuous trackers on the market read from this interstitial fluid, as blood glucose diffuses very quickly into it, making it highly indicative of exact levels at any given time. The latest Dexcom device, the G6 is slightly different then the G5.
The G5 and G6 is worn on the upper abdomen and Dexcom boasts that it’s the only one on the market that lets people make treatment decisions from the information. Dexcom states that readings from the device can determine if people should eat carbohydrates or take their insulin which is very unique because competitive devices don’t have that same level of performance.
The G5 is primarily used for patients with Type 1 diabetes, or who intensively manage their diabetes with insulin, but that Dexcom G5 and new G6 is also starting to see some usage by Type 2 sufferers and can be used by a HealthCoach – Gerald J. Joseph
- 442 million people worldwide have diabetes
- Sufferers of type 1 diabetes have a lack of insulin production, while in type 2 the body gradually becomes resistant to the insulin it can make
- According to WHO data, diabetes was the sixth leading cause of death globally in 2015,
Overall- the new G6 improves on many fronts over G5, particularly the outstanding new one-button sensor inserter (applicator), strong accuracy without any finger-stick calibrations (maintaining a short two-hour warmup period), an extension to 10-day wear, a slimmer on-body Bluetooth transmitter, and clearance for use with other diabetes devices under an exciting new FDA pathway.
Compared to the G5, which had 7-day sensor wear, the G6 is expected to be more economical due to the longer 10-day wear
HealthCoach will be using the G6 to gather biometric data (blood sugar) in addition (steps, hydration, sleep, BMI, weight) Gerald J. Joseph says – a continuous tracker like the Dexcom G6 will be able to get better analytics to support people to make chronic disease management decisions in real-time – without the inconvenience of daily blood pricks and to communicate with the doctor – nurse – HealthCoach – “data” in a collaborative process in making lifestyle changes.
Dexcom’s G5 and G6 is currently only FDA approved for abdominal use, but soon smart watches may one day perform the same task?
Continuous Glucose Monitors
Like other CGMs – future watches will penetrate the skin to the interstitial space, but with an interchangeable module which will need to be changed once a month, that sits on the back of the watch and pushes the biochemical sensors under the skin. The accuracy rate is at +/- 8%, however it is yet to get the clearance from health regulators to put it in the hands of consumers.
HealthCoach – People with diabetes incur medical costs about 2.3 times higher than those who don’t suffer from the disease.
Non-Invasive Methods – HealthCoach
Sweat contains a small amount of glucose which is derived from blood and interstitial fluid -researchers believe thatsweat glands which are distributed throughout the body could reflect dynamic physiological conditions of body which can help in real time a “HealthCoach” champion lifestyle changes “Gerald J. Joseph” says.
Because the correlation of glucose in sweat is much lower than that in the blood, sensitive sensors must become more accurate to match the accuracy of a direct reading of interstitial fluid or blood.
The correlation between sweat and blood glucose also needs to be studied more thoroughly
As for what the future holds – wearable glucose tracking is coming! For Diabetics, there are other factors to consider than just keeping an eye on their blood.
They are at risk for neuropath – open wounds damaging nerves and more prone to foot injuries that don’t heal easily. Early detection is essential and I foresee in the future socks helping the doctor – healthcoach detect increased blood sugar levels.
Our bodies respond to injury with inflammation, which causes heat; socks in the future will alert the wearer with a notification on their smartphone (HealthCoach) when they detect rising temperature in specific areas of the foot.
For proper diabetic foot care, I recommend wearing fresh cotton white socks and replace socks every month to avoid thinning especially with patients who have lost a toe or have had multiple ulcers – in addition to consuming my HealthCoach diet.
Detecting a massive intake of sugar levels in real time can help you see what sugary foods do to your body in real time – maybe you’ll be less likely to reach for a soda, or even a donut or cookie and just maybe the next time you may choose a delicious whole fruit snack.
More specifically non-invasive continuous glucose monitoring can essentially track your glucose levels just like wearables track your heart rate now. You’d have a daily, minute-by-minute break down throughout your day and no when you’ve been naughty.
You, your doctor and or your HealthCoach could then better and more instantly tweak your diet. And since diet is half of maintaining a healthy lifestyle, it could completely change people’s lives.
There are different levels of glucose monitoring.
Non-invasive continuous glucose monitoring would more likely impact everybody, largely because you’d get that near-instant feedback loop between what you eat and how your glucose is affected.
The level below that is just non-invasive glucose monitoring – this would allow something like a fitness tracker to track your glucose, but not all the time – perhaps at hourly intervals. It would be nice, but it’s not as game-changing as continuous glucose monitoring.
Let’s also not forget that there are around 100 million Americans living with diabetes. Non-invasive glucose monitoring would be a major quality-of-life upgrade, saving them a prick on the finger.
It’s one thing to be able to do non-invasive continuous glucose monitoring, it’s another thing to be able to do it so well it can help advise on insulin dosage for those with diabetes.
Let’s Look Deeper – The Science
The problem is really about the laws of physics – you simple can not draw that much data from things like interstitial fluid at this time – More on this and how the Gerald J. Joseph – HealthCoach Prevention Program (HCPP) affects blood sugar (HbA1c)- in part II.
It does look like Continuous Non-Invasive Glucose Monitoring seems to actually be working and finally doctors and patients are going see how a can of Coke, grains and or processed foods affects blood sugar.
THE NEXT WAVE OF FITNESS WEARABLES WILL SEND DATA DIRECTLY TO DOCTORS – HEALTHCOACH
You’re committed to becoming more active and healthy. So you join a gym, find a workout buddy, or hire a personal trainer. And like more and more of us, you might also buy a fitness tracker—a wearable wireless device with built-in sensors that measure your physical activity. According to a Gartner study, 68.1 million wearable fitness trackers are expected to sell in 2015, and 91.3 million in 2016.
The North America Fitness Tracker Market is expected to witness market growth 17.2% CAGAR during the forecast period (2017 – 2023).
HealthCoach Data Trackers
These mostly wrist-worn devices can tell you far more about your physical activity than the humble pedometer ever could. Current trackers—both dedicated devices and smartwatches with sensors—can measure your heart rate, distance traveled, speed, altitude, calories consumed, and even your sleep patterns the night before. As they evolve, and new kinds of sensors are built in, they can do what some targeted, wearable medical devices (such as blood glucose meters and cardiac monitors) can already do: Things like checking your breathing rate, stress level, and different types of brain activity.
But does the average user know what to do with—or even want—all this information? Does the average person really want to become the quantified self, continually measuring, examining, and evaluating their own physical data? Perhaps not: A study by tech consultants Endeavour Partners found more than half of US consumers who have owned an activity tracker no longer use it.
Dr. Steven Steinhubl, director of digital medicine and cardiologist at Scripps Translational Science Institute, has an idea of why this might be.
“For all of these devices, there has to be this back-end that gives you the useful kind of information that they want from that device,” he said. “There’s that rare ‘quantified self’ who really wants to look at all of the data in a new way and understand. But there’s going to be a much larger percentage of individuals who, the more their activity tracker bothers them, the less they’re going to want to wear it. We have to be able to provide those people with actionable, useful information, only when they need that information, and not just arbitrarily.”
Therein lies the challenge. Developers are taking it on, working on products that translate physical data into personalized feedback that can help users become more active. In addition to popular existing apps like My Fitness Pal, new kinds of personal analytics apps are cropping up. Lark, for example, tracks workouts via smartphone sensors, acting as a personal coach and cheerleader users can “chat” with. The app analyzes a user’s daily activities, suggests workouts based on those activities, and sends encouraging texts—say, a compliment on your choice of a salad for lunch.
Another web app, Exist, examines data from services a person already uses—Fitbit, iCal, Twitter, and Spotify, for example—and analyzes his or her habits across the different services. The app gets smarter and more personal over time, using data from the last 90 days to suggest new fitness goals.
These technologies that can collect and leverage someone’s physical information could lead to better overall health. Leading the way is Qualcomm Life’s 2net platform, a cloud-based system that captures, transmits, and aggregates biometric data from medical devices and sensors, so health care providers, family caregivers, and patients have access to the data. The 2net hub and 2net mobile products collect biometric data via short-range radios, then encrypt it and send it to the cloud-based 2net platform via cellular technology.
Data sent to the 2net platform can be also synced with Qualcomm Life’s HealthyCircles Care coordination platform, an enterprise software-as-a-service (SaaS) solution that provides a secure communications and record-sharing infrastructure for care-team coordination. Through smart algorithms and exception-based management protocols within the HealthyCircles platform, a heart-failure patient’s blood pressure measurements could trigger an alert for a nurse case manager or doctor to check in on the patient, for example. And patients and family caregivers can monitor and manage the patient’s health status from home.
Developments like 2net and HealthyCircles are only the beginning of the quantified-self movement and health care. Connected health services will evolve with the data-collecting wearables that drive them. In-ear “earables” will measure body temperature and blood pressure very accurately. Wearables may even be invisible one day, replaced by hidden technology such as MC10’s tiny, see-through stickers—equipped with a battery and sensor—that sit on the skin.
As wearables are integrated into these health and fitness channels, health care professionals will look to the data collected on an everyday basis, rather than a yearly physical exam, ultimately shifting from an encounter-based health care to continuous care. Doctors will be more involved in a patient’s recovery and overall well-being. And an individual’s TMI data will become truly useful. It’s a paradigm shift in healthcare that will leave everyone feeling good.
HealthCoach – The HealthCoach Prevention Program (HCPP) uses data from anthropological studies of modern day hunter-gatherer populations, Blue Zone regions around the world with high concentration of centenarians, and clinical studies to develop wellness protocols that can prevent and potentially reverse chronic disease syndromes and cognitive loss disorders.
HealthCoach Prevention Program (HCPP) Coming 2020
Gerald J. Joseph International, LLC – Thank you Qualcomm for the great insights.
TURNING BACK THE BIOLOGICAL AGING CLOCK
Telomere extension turns back aging clock in cultured human cells, study finds.
Researchers delivered a modified RNA that encodes a telomere-extending protein to cultured human cells. Cell proliferation capacity was dramatically increased, yielding large numbers of cells for study.
A new procedure can quickly and efficiently increase the length of human telomeres, the protective caps on the ends of chromosomes that are linked to aging and disease, according to scientists at the Stanford University School of Medicine.
Treated cells behave as if they are much younger than untreated cells, multiplying with abandon in the laboratory dish rather than stagnating or dying.
The procedure, which involves the use of a modified type of RNA, will improve the ability of researchers to generate large numbers of cells for study or drug development, the scientists say. Skin cells with telomeres lengthened by the procedure were able to divide up to 40 more times than untreated cells. The research may point to new ways to treat diseases caused by shortened telomeres.
Telomeres are the protective caps on the ends of the strands of DNA called chromosomes, which house our genomes. In young humans, telomeres are about 8,000-10,000 nucleotides long. They shorten with each cell division, however, and when they reach a critical length the cell stops dividing or dies. This internal “clock” makes it difficult to keep most cells growing in a laboratory for more than a few cell doublings.
‘Turning back the internal clock’
“Now we have found a way to lengthen human telomeres by as much as 1,000 nucleotides, turning back the internal clock in these cells by the equivalent of many years of human life,” said Helen Blau, PhD, professor of microbiology and immunology at Stanford and director of the university’s Baxter Laboratory for Stem Cell Biology. “This greatly increases the number of cells available for studies such as drug testing or disease modeling.”
A paper describing the research was published today in the FASEB Journal. Blau, who also holds the Donald E. and Delia B. Baxter Professorship, is the senior author. Postdoctoral scholar John Ramunas, PhD, of Stanford shares lead authorship with Eduard Yakubov, PhD, of the Houston Methodist Research Institute.
The researchers used modified messenger RNA to extend the telomeres. RNA carries instructions from genes in the DNA to the cell’s protein-making factories. The RNA used in this experiment contained the coding sequence for TERT, the active component of a naturally occurring enzyme called telomerase. Telomerase is expressed by stem cells, including those that give rise to sperm and egg cells, to ensure that the telomeres of these cells stay in tip-top shape for the next generation. Most other types of cells, however, express very low levels of telomerase.
Transient effect an advantage
The newly developed technique has an important advantage over other potential methods: It’s temporary. The modified RNA is designed to reduce the cell’s immune response to the treatment and allow the TERT-encoding message to stick around a bit longer than an unmodified message would. But it dissipates and is gone within about 48 hours. After that time, the newly lengthened telomeres begin to progressively shorten again with each cell division.
The transient effect is somewhat like tapping the gas pedal in one of a fleet of cars coasting slowly to a stop. The car with the extra surge of energy will go farther than its peers, but it will still come to an eventual halt when its forward momentum is spent. On a biological level, this means the treated cells don’t go on to divide indefinitely, which would make them too dangerous to use as a potential therapy in humans because of the risk of cancer.
This new approach paves the way toward preventing or treating diseases of aging.
The researchers found that as few as three applications of the modified RNA over a period of a few days could significantly increase the length of the telomeres in cultured human muscle and skin cells. A 1,000-nucleotide addition represents a more than 10 percent increase in the length of the telomeres. These cells divided many more times in the culture dish than did untreated cells: about 28 more times for the skin cells, and about three more times for the muscle cells.
“We were surprised and pleased that modified TERT mRNA worked, because TERT is highly regulated and must bind to another component of telomerase,” said Ramunas. “Previous attempts to deliver mRNA-encoding TERT caused an immune response against telomerase, which could be deleterious. In contrast, our technique is nonimmunogenic. Existing transient methods of extending telomeres act slowly, whereas our method acts over just a few days to reverse telomere shortening that occurs over more than a decade of normal aging. This suggests that a treatment using our method could be brief and infrequent.”
Potential uses for therapy
“This new approach paves the way toward preventing or treating diseases of aging,” said Blau. “There are also highly debilitating genetic diseases associated with telomere shortening that could benefit from such a potential treatment.”
Blau and her colleagues became interested in telomeres when previous work in her lab showed that the muscle stem cells of boys with Duchenne muscular dystrophy had telomeres that were much shorter than those of boys without the disease. This finding not only has implications for understanding how the cells function — or don’t function — in making new muscle, but it also helps explain the limited ability to grow affected cells in the laboratory for study.
The researchers are now testing their new technique in other types of cells.
“This study is a first step toward the development of telomere extension to improve cell therapies and to possibly treat disorders of accelerated aging in humans,” said John Cooke, MD, PhD. Cooke, a co-author of the study, formerly was a professor of cardiovascular medicine at Stanford. He is now chair of cardiovascular sciences at the Houston Methodist Research Institute.
“We’re working to understand more about the differences among cell types, and how we can overcome those differences to allow this approach to be more universally useful,” said Blau, who also is a member of the Stanford Institute for Stem Cell Biology and Regenerative Medicine.
“One day it may be possible to target muscle stem cells in a patient with Duchenne muscular dystrophy, for example, to extend their telomeres. There are also implications for treating conditions of aging, such as diabetes and heart disease. This has really opened the doors to consider all types of potential uses of this therapy.”
Krista Conger, Stanford co-authors – Jennifer Brady, PhD, and Moritz Brandt, MD; senior research scientist Stéphane Corbel, PhD; research associate Colin Holbrook; and Juan Santiago, PhD, professor of mechanical engineering.
This work was supported by the National Institutes of Health (grants R01AR063963, U01HL100397 U01HL099997 and AG044815), Germany’s Federal Ministry of Education and Research, Stanford Bio-X and the Baxter Foundation.
Ramunas, Yakubov, Cooke and Blau are inventors on patents for the use of modified RNA for telomere extension.
Gerald J. Joseph HealthCoach 2019
HEALTHCOACH – CORPORATE WELLNESS
The “Unclogging” of Healthcare Delivery
HealthCoach- Corporate Wellness
A well-crafted Corporate Wellness Program adapts easily to the digital world of smartphone messaging, wearable biometric data, content delivery and modern wellness strategies.
As we move deeper into the 21st century of healthcare delivery, it has become readily apparent that the epidemic of chronic disease will remain the primary focus of most reform measures by necessity. The United States currently spends 18% of its GDP on healthcare (4,13) and at least 70% of these costs are related to the management of preventable chronic health conditions (6). These costs are projected to double every 25 years, reaching 34% by 2040, and are largely felt to be unsustainable. To respond to this crisis, the United States enacted the Affordable Care Act which seeks to incentivize improved health at a reduced cost through the use of “Big Data” to identify modifiable risk factors in a given population. The “Big Data” approach to achieving cost-effective outcomes is being used in most other industries and healthcare has finally caught on to its potential value.
According to the World Health Organization, 80% of heart disease, stroke, and type 2 diabetes could be prevented and 40% of cancer could be prevented (1). These are the major conditions that are driving increased healthcare costs within the United States. In order to harness the tremendous opportunity to save money by preventing these conditions even before symptoms have appeared, providers will need to shift resources away from costly and risky medical services to less costly and safer preventive services. The United States currently spends 96% on medical services and only 4% on prevention (6).
The United States currently spends 96% on medical services and only 4% on prevention
The Centers for Disease Control reports that the leading drivers of death and disability mostly related to these chronic conditions are poor diet, reduced physical activity, and cigarette smoking. Even though this information has been widely disseminated, less than 3% of the public is following all of the CDC’s recommendations for living a healthy lifestyle (25) and less then 50% are adhering to their medication prescriptions written mostly to stabilize the effects of these lifestyle “risk factors” (37).
This lack of adherence to lifestyle recommendations and to medication prescriptions has resulted in poor control of disease precursors like blood lipids, blood pressure, and blood sugar (targets are being met <50% of the time, 36).
To better understand why lifestyle factors are so important for health, research anthropologists report (21, 20) that the human genetic make-up has changed little in the past 40,000 years and that modern humans are genetically best adapted to:
- Eat natural foods from the earth
- Live outdoors with moderate exposure to the sun
- Live among others in supportive groups
- Sleep when the sun goes down and awaken as the sun comes up
- Walk 5-10 miles each day
- Exhibit a stress response to short-lived stressors and then return to relaxation
They point out that there is a mismatch between how our ancestors lived for 2.5 million years and how we began living only 10,000 years ago after the agricultural revolution (farming, domesticated animals, grains, dairy) and 200 years ago after the industrial revolution (cities, indoor living, decreased family support, decreased physical activity). These mismatches have increased dramatically in the past 30 years:
- Sugar consumption has increased from about 2 pounds per person per year at the beginning of the 20th century to about 150 pounds today (7)
- Processed foods made from refined sugars, cereals, refined vegetable oil, alcohol and dairy products has reached 72% of adult calorie intake (2)
- 79.4% of Americans are physically inactive (3)
- Vitamin D deficiency predominantly from lack of sunlight exposure has reached 82% in some populations (23)
- 18.2 % of the population continues to smoke (6, 3)
- 17.4% of youths age 12-17 use either alcohol or drugs (6, 3)
The best evidence tells us that these mismatches are major contributors to the onset of type 2 diabetes, heart disease, stroke, cancer, Alzheimer’s disease, liver and kidney disease, depression, falls, disability and death (6,1,3,8,9,14,22). These conditions account for most of the chronic disease burden seen around the world and data from the CDC reveals that genetic make-up contributes only 15-18% to the causes of these conditions. The other 80-85% consists of health behaviors, psychosocial factors, and environmental exposures (6, 1).
Our current healthcare system has focused resources mostly on providing care after symptoms, disease, and disability have appeared, instead of focusing on prevention (1,6,19,20,1,11). Healthcare payments tied to fee for service have incentivized care delivery to provide services after blood vessels have become “clogged” (diabetes, coronary heart disease), joints have become arthritic (osteoarthritis, rheumatoid arthritis, lower back pain), and organs have become impaired (cirrhosis, Alzheimer’s disease, kidney failure). Each year in the United States, 2.4 million angiograms, 1 million knee and hip replacements, and 51.4 million medical procedures are carried out (6).
To further frame the problem in the United States:
- We spend 2 ½ times more then the average of our peer nations on healthcare per capita per year (25)
- We rank 37th in overall population health compared to our peer nations (8)
- 77% of those over age 65 have either pre-diabetes or diabetes (9)
- Diabetes accounts for >20% of healthcare costs (9)
- Diabetic patients cost 2.3 times more then non-diabetics each year on average for healthcare (9)
- We rank #1 in the world in prescription drug use (5)
- 76% of every clinical encounter in the U.S. involves a medication (28)
- 80% of the worlds opiate pain pills are prescribed in the United States (27)
- 70% of Americans take one medication, 50% take two, and 20% take five. (26)
- 1/3 of older adults over age 65 fall each year and that increases to 50% for those over age 80 (6)
Now more then ever, we can’t afford to wait for symptoms, disease, or disability to occur before we actively and continuously engage patients in the work of self-care. We need to implement a prevention and wellness delivery system that supports patients in the work of building resiliency by self-managing conditions and lifestyle particularly in between acute episodes of care.
We can’t afford to wait for symptoms, disease, or disability to occur
Our emphasis on pharmaceutical and medical service prescription for chronic disease is unsustainable and has to change if we are to have the necessary resources to maintain our quality of life and our position in the world as a major power. We must now shift to a lower cost prevention and wellness model of care for chronic illnesses and this is exactly what leaders in healthcare innovation are pursuing. By improving health outcomes through this lower cost approach, we could allocate some of these saved resources to other societal problems such as crime, education, poverty and job creation (4).
Our emphasis on pharmaceutical and medical service prescription is unsustainable.
Lessons learned from Medicare’s pioneer ACO pilot programs tell us that we must reduce medical services by preventing “rising risk” patients from becoming “high risk” patients in order for healthcare to become financially viable in the long term (19). This is why the Institute of Medicine, the CDC (6), the Institute for Healthcare Improvement (33), the American Academy of family Physicians (34), and the Centers for Medicare and Medicaid (30) are calling for a shift in care away from reactive disease management to proactive disease prevention.
These organizations are calling for a reorganization of primary care into highly functioning physician-led prevention teams like the patient-centered medical home where each member of the team takes on different responsibilities and works at the top of their license. The team focuses on prevention and wellness of their assigned population and engages patients in the work of self-management.
Self-management support is a KEY intervention for preventing chronic illness (35) but physicians have received little training in team-based care and in condition or lifestyle self-management prescription (38). In addition, both providers and patients have become accustomed to the medication or procedure-based encounter pointing to the additional challenge of creating a “culture” of prevention and wellness (24, 28).
Self-management support is a KEY intervention for preventing chronic illness
Pre-existing models of successful self-management support programs include cardiac rehabilitation (32% improvement in cardiac mortality) (17), pulmonary rehabilitation (37% reduction in acute hospitalizations for COPD) (16), and the diabetes prevention program (70% reduction in onset of diabetes for older pre-diabetic patients) (14).
The Institute of Medicine has recently called for medical education reform to meet the new demand for prevention and wellness delivery within primary care (10) but this could take many years to implement once medical schools finally embrace these recommendations.
To further elucidate the healthcare “cultural” problem, patients report that they would rather take medications or undergo surgery then make changes in their health behaviors to reduce chronic disease risk factors (24). In order to change this paradigm, the American Hospital Association has called for the enactment of a “culture of wellness” throughout our systems of care (29).
They recognize that the cultural disconnect between the OLD way of reactive care delivery and the NEW way of preventive care delivery. Changing culture takes time and this will be a significant challenge for 21st century healthcare. The providers who succeed in making this cultural shift sooner then later will be the winners within the NEW value-based payment system that is emerging (19).
Patients report that they would rather take medications or undergo surgery then make changes in their health behavior
Leaders from the Robert Wood Johnson Foundation (11), from Kaiser-Permanente (31), from Cleveland Clinic (32) and many other integrated care systems (18) are working to prevent disease at every level within the chronic disease lifecycle. They are calling for prevention and wellness integration as a primary focus for better outcomes delivery at a reduced cost. This is consistent with Medicare’s triple aim vision for the future of healthcare (18).
With the shift to electronic medical records and the push to get patients “into the system”, more providers will be able to use BIG DATA to identify the right risks for prevention so that limited resources can be targeted in the right way. This is what the Robert Wood Johnson foundation calls “A Prescription for Health” (12) and this is what will sustain healthcare delivery in the long term.
HealthCoach – tracks biomarker information like steps per day, weight (loss or gain), BMI, continuous blood sugar, sleep, hydration and food choices – as well as a host of other cohorts through fitness tracking technology.
HealthCoach – allows doctors, participants and health coaches to use secure HIPAA messaging or video conferencing to help with better food choices, to encourage consistent steps per day, to insure safe weight loss and to communicate data back to the doctor for reassessment every 90 days.
- Preventing chronic diseases: a vital investment WHO, 2005
- Origins and evolution of the Western diet: Health implications for the 21st century, Loren Cordain, Am J Clin Nutr, February 2005
- Congressional Budget Office, 2009
- Extent and causes of international variations in drug usage. A report for the Secretary of State for Health. July, 2010, UK
- The Power of Prevention: The Public health Challenge of the 21st Century, CDC 2009
- The State of U.S. Health, 1990-2010, JAMA, July 2013
- Diabetes Fact Sheet, 2011, CDC.gov
- Interview Gail Wilensky, Institute of Medicine Co-chair, Committee on the Governance and Financing of Graduate Medical education, July 2014
- Interview with James Marks, Director of Program Portfolios, RWJF, US 1 Magazine, Princeton, N.J.
- Council of Economic Advisors, Whitehouse.gov
- Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin, Diabetes Prevention research Group, NEJM; Vol 346:6, 394-403
- Institute of Medicine. Preventing Medication Errors: Quality Chasm Series, Washington, DC: National Academy Press; 2007.
- Olivia Revitt, Louise Sewell et. al., Short outpatient pulmonary rehabilitation program reduces readmission following a hospitalization for an exacerbation of chronic obstructive pulmonary disease, Respirology, Volume 18, Issue 7, pages 1063–1068, October 2013
- Rod S. Taylor, Allan Brown et al., Exercise-Based Rehabilitation for Patients with Coronary Heart Disease: Systemic Review and Meta-analysis of Randomized Controlled Trials, Am J Med 2004; 116: 682-692
- Population Health, Healthcare Informatics Webinar, Advisory Board Research, March 2014
- S. Boyd Eaton, Beverly I. Strassman, Randolph Nesse et al., Evolutionary Health Promotion, Preventive Medicine 34, December 2001, 109-118
- Evolution in Health and Disease (Oxford Biology): January 10, 2008 by Stephen C. Stearns and Jacob C. Koella
- Dale Bredesen, Reversal of cognitive decline: A novel therapeutic program, AGING, September 2014, Vol 6 N 9
- Forrest KY1, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011 Jan;31(1):48-54.
- Allan S. Detsky M.D., PhD, What patients really want from health care? JAMA, December 14, 2011, Vol 306, No. 22
- OECD Health Data, 2012
- May Clinic Proceedings, June 2013
- ABC News, April 20, 2011
- CDC Faststats, 2013
- A Call to Action: Creating a Culture of Health, American Hospital Association, January 2011
- CMS Comprehensive Primary Care Initiative, June 2012 Webinar
- Healthcare Will Note Reform Itself, George Halvorson, CEO Kaiser Permanente, 2009
- The Cleveland Clinic Way: Lessons in Excellence from One of the World’s Leading Health Care Organizations Hardcover – January 7, 2014 by Toby Cosgrove
- Institute for Healthcare Improvement, triple Aim for Populations, http://www.ihi.org/Topics/TripleAim/Pages/Overview.aspx
- American Academy of family Physicians, Summary of Recommendations for Clinical Preventive Services, November 2014
- Mary Thoeson Coleman, Karen S. Newton, Supporting Self-management in Patients with Chronic Illness, American Family Physician, 2005 Oct 15; 72 (8): 1503-1510
- Cardio metabolic Health Congress, Statement of Need, http://www.cardiometabolichealth.org/2013/accreditation.asp
- Top 10 Prescription Drugs in the U.S., Institute for Healthcare Informatics, 2010
- Doctors and Patients, Not Talking About Weight, New York Times, March 16, 2010
- Stephen B. Lewis M.D., FABPMR
The Gerald J. Joseph – HealthCoach Prevention Program (HCPP) empowers both doctors, patients and participants to improve treatment outcomes by safely engaging patients in health-behavior change supported by diet, organic nutraceuticals, and walking.
HealthCoach communicates with participants on a daily basis, and the patient’s physician reviews the results every 90 days.
Participants have the option to be tracked, measured, and monitored in a comprehensive manner by a HealthCoach. This allows for a more complete and customized review of lifestyle activities and biomarkers such as steps, weight, BMI, hydration, blood pressure, continuous blood sugar and sleep.
HealthCoach communicates with you via smart phone, text messaging, and email and is available to you 24/7. This ensures you’re never far away from a motivating message, an answer to a question, a friend to communicate with, or a great meal suggestion.
The HealthCoach Prevention Program is highly individualized and designed to improve both chronic health conditions and cognitive loss.
HealthCoach supports, mentors and tracks participants as a wellness authority, helping my people feel their best through food and lifestyle changes, tailoring individualized and corporate wellness programs to improve health outcomes
ALZHEIMER’S DISEASE, AN EVOLUTIONARY NEUROSCIENCE PERSPECTIVE – HEALTHCOACH
The Coevolution of Man & Food – Nature Got It Right
Alzheimer’s Disease – Gerald J. Joseph – The HealthCoach Prevention Program
INTRODUCTION Part 1
Alzheimer’s disease is now the third leading cause of death in the United States, following only by cardiovascular disease and cancer . There are approximately 5.2 million Americans with AD, but this estimate ignores the many young Americans destined to develop AD during their lifetimes: given the lifetime risk of approximately 15% when including all ApoE genotypes, as many as 45 million of the 318 million Americans now living may develop AD during their lifetimes if no prevention is instituted .
There is increasing urgency to develop effective prevention and treatment for Alzheimer’s disease (AD) as the aging population swells. Yet, our understanding remains limited for the elemental pathophysiological mechanisms of AD dementia that may be causal, compensatory, or epiphenomenal.
To this end, I hypothesis why AD exists from an evolutionary perspective which includes natural selection, co-evolution, adaptation, genetic drift, and other evolutionary forces. (In Part 2 I will describe the mechanism of action and how to successfully treat AD with diet, antioxidant/phytonutrient nutraceuticals and walking)
As baby boomers enter the vulnerable ages for Alzheimer’s disease (AD), biomedical research is in a race against time to prevent, stabilize, or cure the disease. Implicitly or explicitly, rational therapeutic discovery relies on understanding the root cause (s) as well as intermediate and proximate pathophysiological processes of disease.
Basic research on AD has historically focused on characterizing the signature pathological lesions, that is, amyloid-β (Aβ) neuritic plaques and paired helical filament tau (PHFtau) neurofibrillary tangles, and the precedent and consequent molecular, biochemical, and physical mechanisms that most likely link these disease lesions to the neurodegeneration and cognitive decline caused by AD. 
Viewing AD from an evolutionary perspective prompts a rethinking of the way we describe the relationship between the clinical dementia and the neuropathology by which we define the disease. By integrating the fields of phylogeny, life history theory, genetics, biochemistry, nutrition, exercise science and evolutionary medicine, a unified theory of AD can be developed and a protocol to prevent AD established. (TJP)
My hypotheses on the root cause (s) of AD centers on the consumption of the Western American diet (malnutrition), the lack of persistence exercise (walking) and the reduction of consuming plant-based foods high in antioxidants.
Over the past decade, neuroscientists have identified that physical activity stimulates both neurogenesis (the birth of new neurons) and optimizes functional connectivity within the human brain via neuro- plasticity.
High consumption of plant-based foods and regular aerobic exercise produce many neuroprotective benefits—and when both are combined, they are the most effective way to bulk up gray matter brain volume, elongate telomeres and improve the integrity of your brain’s white matter communication lines.
From an evolutionary neuroscience perspective, physical activity stresses brain function because of the cognitively demanding activity of constantly looking for foods which forced our ancestors to engaged in daily aerobic physical activity. In addition to traveling great distances daily, man co-evolved consuming high antioxidant fruits/berries and high omega 3 fatty acids rich foods from both vegetables, fungi, fruits and from the sea.
(The hunter–gatherers‘ daily energy expenditures for physical activity typically were at least 800 to 1200 kcal, 41 or about 3 to 5 times more than the average American adult today)
Simply put, our ancient genome has not had enough time to adapt to a non-daily aerobic activity lifestyle of our modern – get in your car, go buy groceries in a store – modern world.
Moreover, recently introduced foods such as grains, refined sugar, trans-fats, corn-fed altered animal, fowl, dairy proteins, alcohol and synthetic chemicals in processed food production further compromise our pre-designed constitution. The human body was designed very specifically to eat whole non-processed foods and to walk great distance daily.
By returning to this original design plan – and implementing a simpler ancestral hunter-gatherer diet which consists of ~70% of kilocalories that come from plant foods – whole fruits, root vegetables, Fungi, sea vegetables, land vegetables, bulbs, nuts and seeds, and ~30% of kilocalories of the annual diet from marine cold-water fish, eggs, and lean/low-fat grass-fed animal proteins like our ancestors did, we can improve the quality of our health and sustain our lifespan over a longer period of time. 
In conclusion, [s]cientists have discovered that exercise appears to build a brain that resists physical shrinkage and enhances cognitive flexibility. Exercise, the latest neuroscience suggests, does more to bolster thinking than thinking does. Daily exercise when combined with a high plant-based fatty acid -antioxidant rich diet, challenges the brain to respond by increasing its neuroplasticity, by increasing more myelin, and healthy synaptic connections. All of these essentials promote and improve better neural signaling which enhances cognitive function.
The HealthCoach Prevention Program (HCPP)
HealthCoach– is a multi-modal program consisting of diet, nutraceuticals and walking designed to impact and enhance neurogenesis in three regions of the brain.These three regions of the brain, subgranular zone (SGZ) of the hippocampus which is involved in regulating learning and memory, the subventricular zone (SVZ) and the Amygdala are measurable affected in Alzheimer’s disease syndromes.
HealthCoach– targets these three regions though diet, nutraceuticals and walking to promote neurogenesis. (See Nutraceuticals – Super Greens – Antioxidant Berries)
Both anthropologists and nutritionists have long recognized that the diets of modern-day hunter-gatherers may represent a reference standard for modern human nutrition and a model for defense against certain diseases of affluence. 
HealthCoach – diet protects against oxidative stress which is an imbalance between production and accumulation of oxygen reactive species (ROS) in cells and tissues and the ability of a biological system to detoxify these reactive products. 
These phenomena are mainly initiated and enhanced by oxidative stress, a process referring to an imbalance between antioxidants and oxidants in favor of oxidants. Thus, tissues and organs, particularly the brain are affected by ROS due to its composition. The brain is largely composed of easily oxidizable lipids while featuring a high oxygen consumption rate.
Antioxidants are molecules that fight damage by free radicals, unstable molecules that can harm cellular structures. Antioxidants do this by giving electrons to the free radicals and neutralizing them.
Inflammation in the brain, in particular activation of microglia, has been increasingly associated with the pathogenesis of Parkinson’s disease (PD), as well as several other neurodegenerative disorders.
Recent clinical research has demonstrated that berry fruits can prevent age-related neurodegenerative diseases and improve motor and cognitive functions. The berry fruits are also capable of modulating signaling pathways involved in inflammation, cell survival, neurotransmission and enhancing neuroplasticity.
The neuroprotective effects of berry fruits on neurodegenerative diseases are related to phytochemicals such as anthocyanin, caffeic acid, catechin, quercetin, kaempferol and tannin.
Numerous natural antioxidant/anti-inflammatory compounds found in plant food matrices, like fruits, especially berries (such as strawberry, bilberry, blackcurrant, blackberry, blueberry and mulberry) can offer neuroprotective effects.
Anthocyaninsare a type of flavonoid, are a family of powerful antioxidants that fight the effects of aging and oxidative stress. To date, more than 635 different anthocyanins have been identified.
Anthocyanins (from the Greek anthos for flower and kyanose for blue) are water-soluble polyphenols flavonoid compounds.
HealthCoach – diet, nutraceutical and walking program recognizes that sedentary individuals who increase their steps from 1,000 to 3,000 a day reduced their mortality risk by 12%; those who achieved 10,000 daily steps cut their risk by 46%.
HealthCoach – diet, nutraceutical and walking program recommends a gradual increase in daily steps to a minimum 5000 steps a day and optimally 10,000 steps a day.
Physical activity such as walking may preserve neuronal plasticity, increase synapse formation, and cause the release of hormonal factors that promote neurogenesis and neuronal function.
Decreased cerebrovascular blood flow and function are associated with lower cognitive functioning and increased risk of neurodegenerative diseases. Walking produces large pressure waves in the body that significantly increase blood flow to the brain.
Anthocyanins are a type of flavonoid, a class of compounds with antioxidant effects. Found naturally in a number of foods, anthocyanins are the pigments that give red, purple, and blue plants their rich coloring.
Anthocyanins may have a protective role in plants against extreme temperatures. For example, tomato plants protect against cold stress with anthocyanins countering reactive oxygen species, leading to a lower rate of cell death in leaves.
In addition to acting as antioxidants and fighting free radicals, anthocyanins may offer anti-inflammatory, anti-viral, and anti-cancer benefits.
Blueberries contain the following anthocyanins: malvidin 3-galactoside, delphinidin 3-galactoside, delphinidin 3-arabinoside, petunidin 3-galactoside, petunidin 3-arabinoside, malvidin 3-arabino-side, cyanidin 3-glucoside, cyanidin 3-galactoside, cyanidin 3-arabinoside, delphinidin 3-glucoside, malvidin 3-glucoside, peonidin 3-glucoside, peonidin 3-galactoside, peonidin 3-arabinoside, and peonidin 3-glucoside
Another large body of research from the Nurses’ Health Study I and II, which followed over 46,000 women from and 23,000 men for more than a decade, found evidence that the those with the highest intakes of anthocyanin (especially from blueberries and strawberries) had a significantly decreased risk for developing hypertension, myocardial infarction and/or having a heart attack compared to those with the lowest intake. This was true even after controlling for other factors like exercise level, family history and BMI.
Chronic food deficits affect about 792 million people in the world. Malnutrition directly or indirectly affects a variety of organ systems including the central nervous system (CNS). A number of nutritional conditions are included in the Global Burden of Disease (GBD) study, such as protein–energy malnutrition, iodine deficiency, vitamin A deficiency, and iron deficiency anemia. Over 15% of the disability- adjusted life years (DALYs) lost globally are estimated to be from malnutrition.
Micronutrients is the term used for those essential nutrients that are needed in small amounts for human growth and functioning. They are essentially used as cofactors for enzymes engaged in various biochemical reactions. They comprise vitamins, fat-soluble as well as water-soluble, and trace elements (= minerals). Iron, vitamin A, zinc and iodine are most discussed today, but other important micronutrients are vitamin C and the vitamin B complex.
Parkinson’s disease is a chronic progressive neurodegenerative disorder of insidious onset, characterized by the presence of predominantly motor symptomatology (bradykinesia, rest tremor, rigidity, and postural disturbances).
It is also associated with a diversity of non-motor symptoms, which, together with late-onset motor symptoms (such as postural instability and falls, freezing of gait, speech and swallowing difficulties), are presently one of the most difficult challenges the treating physician is faced with when dealing with patients with a long duration of the disease.
The “Western diet”, in particular a low fiber – high fat – high carbohydrate grain-based diet can lead to malnutrition and severe gut dysbiosis.
In contrast, a high plant-based diet that includes abundant whole fruits, vegetables, olive oil and oily fish are known for their anti-inflammatory effects – could prevent malnutrition and gut dysbiosis.
The human gut microbiota (GM) is vital for host nutrition, metabolism, pathogen resistance and immune functionand varies with diet, lifestyle and environment. The Hadza lifestyle therefore is thought to most closely resemble that of Paleolithic humans.
Parkinson’s disease (PD) affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra.
Neurogenesis in the adult mammalian brain is generally accepted to occur in two discrete regions: the hippocampus and olfactory bulb. In recent years, there have been reports that neurogenesis may also occur in other regions of the adult brain under normal conditions, such as the neocortex and amygdala. Moreover, various brain insults have been shown to induce the production of new neurons in the striatum and cortex.
In part 2, I will outline how to transition to my Coevolutionary diet, nutraceutical and walking program which will improve health outcomes.
Gerald J. Joseph HealthCoach
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7. David A. Raichlen, Gene E. Alexander. Adaptive Capacity: An Evolutionary Neuroscience Model Linking Exercise, Cognition, and Brain Health. Trends in Neurosciences, 2017; 40 (7): 408 DOI: 10.1016/j.tins.2017.05.001
8. David A. Raichlen, Pradyumna K. Bharadwaj, Megan C. Fitzhugh, Kari A. Haws, Gabrielle-Ann Torre, Theodore P. Trouard, Gene E. Alexander. Differences in Resting State Functional Connectivity between Young Adult Endurance Athletes and Healthy Controls. Frontiers in Human Neuroscience, 2016; 10 DOI: 10.3389/fnhum.2016.00610
9. Raichlen, D. A., Pontzer, H., Harris, J. A., Mabulla, A. Z. P., Marlowe, F. W., Josh Snodgrass, J., Eick, G., Colette Berbesque, J., Sancilio, A. and Wood, B. M. (2016), Physical activity patterns and biomarkers of cardiovascular disease risk in hunter-gatherers. Am. J. Hum. Biol.. DOI: 10.1002/ajhb.22919
10. Coronary atherosclerosis in indigenous South American Tsimane: a cross-sectional cohort study https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30752-3/fulltext?elsca1=tlpr
11. Gut Microbiome of the Hadza hunter-gatherers
BIODIVERSITY, THE FUTURE OF GLOBAL HEALTH: HEALTHCOACH
Biodiversity and Health
Gerald J. Joseph, B.S., M.Ed. HealthCoach
Getting a cold? Take some echinacea. Feeling stressed? Try a little ginseng. Worried and depressed? Perhaps some St. John’s wort will pick you up? According to Bob Stanley, the growth in popularity of these and hundreds of other herbal remedies in Europe and North America has created a multi-billion dollar industry over the past two decades — $27 billion in the US alone in 2001.
While the trend may be new, most of these “alternative medicines” are not as compared to your grandparent’s cures. Some are effective, some are not. Most, though not all, are at least harmless as recent research suggests, however, that plant-based medicines — phytomedicines — may be the key to improving health outcomes of some of the world’s most serious diseases.
In developing countries, traditional herbal remedies are far from a trend. Widely used for millennia, they continue to be the first line of health care for most of the population and growing in popularity in the USA.
What I am taking about are “phytomedicines.” These were the pharmacologists, who use the term to describe their research into plant-based medicine. The prefix “phyto” comes from the Greek word phyton, meaning plant.
A 20-year-old statistic from the World Health Organization (WHO) suggests that 80% of the world’s people rely on traditional medicines and traditional systems of medicine for day-to-day health care. And there is little to suggest that this has changed during the two decades in which the people of the North have been rediscovering herbal remedies. 
Looking to nature for medicine is nothing new – we have been doing it for tens of thousands of years and although modern pharmaceutical science has come a long way from those ancient roots, nature is and will always be an important source of useful compounds and inspiration.
Dismissing nature in this regard is a huge mistake as evolution is the greatest problem solver and the myriad compounds produced by the immense variety of species we share the planet with have been honed by three billion years of trial and error. However, with every bit of habitat that disappears under the plough or concrete we impoverish nature and deprive ourselves of potential medicines.
The preservation of biodiversity is perhaps the single most important building block for achieving the Sustainable Development Goals set by the United Nations. For many of these goals, the importance of preserving biodiversity is obvious, 1) Zero Hunger), 2) Climate Action), 3) Life below Water, and 4) Life on Land.
This argument holds true for the other global goals including, but not limited to, 1) Good Health, 2) Well-being, 3) Reducing Inequalities, 4) Responsible Consumption and Production. Preserving biodiversity in many landscapes and natural habitats free for people to enjoy and access both locally and worldwide, rather than only in museum collections and zoos is critical for understanding life, the workings of the biosphere and for developing methods to sustain the quality and longevity of human life. Of comparable importance, access to biodiversity as a living, evolving aspect of our planet has the potential to increase the public’s appreciation for these systems and processes.
The sustainable development of natural products will not be possible without taking biodiversity conservation into consideration. While plants are commonly used for medicinal purposes, new possibilities are emerging from organisms that are incredibly diverse biologically and chemically, but relatively understudied, such as arthropods and fungi, particularly in many countries deemed as ‘biodiversity hotspots’ 
We can be certain that we share the planet with an enormous variety of species. A very recent estimate of 1-6 billion species is certainly realistic when we take into account parasites, parasitoids and endosymbionts .
Human Disease & Biodiversity
Collecting, curating, and disseminating knowledge on biodiversity as it relates to the treatment of human diseases will promote the conservation of bio- and molecular diversity and, simultaneously, create the international cooperation needed to safeguard well-being for all communities. [4-7]
A new approach is beginning to take hold around alternative medicines, organic food sources, plant-based nutrition and forcing the entire medical community to grapple with certain questions: How has the role of a doctor changed over the years? Are there better ways to treat the kinds of health problems that can usually only be managed, not cured? And how do you gather evidence on therapies that involve not only the body but also the mind?
The bigger problem is that most doctors aren’t well equipped to treat chronic disease as we have an acute-disease system for a chronic-disease population, an approach is to suppress and inhibit the manifestations of disease.
When it comes to thee suppression approach makes sense when you’re trying to solve a sudden flare-up—a high fever, a migraine, or a constriction of the airways during an asthma attack, conventional medicine seams to be working but, when it comes to addressing chronic disease syndromes like heart disease, type II diabetes and obesity, which develops over time, doctors still don’t understand exactly what causes it, what to do about it and how to track patient populations to see if they are improving.
In conclusion, it is crucial that governments, global organizations, and local stakeholders come together to agree on preservation of remaining hotspots of biodiversity through development of partnerships with the medical communities.
I believe that modern medical doctors and research scientists are a highly adaptable professions, with new studies constantly challenging the conventional wisdom, they will come around to the power and use of nature and organic foods sources as preventative tools for our planet and for human health.
NATURE GOT IT RIGHT!
1) Biodiversity, drug discovery, and the future of global health: Introducing the biodiversity to biomedicine consortium, a call to action.
Vidushi Neergheen-Bhujun, Almas Taj Awan, Yusuf Baran, Nils Bunnefeld, Kit Chan, Thomas Edison dela Cruz, Dilfuza Egamberdieva, Simon Elsässer, Mari–Vaughn V. Johnson, Shoji Komai, Andrey L. Konevega, John H. Malone, Paul Mason, Rothsophal Nguon, Ross Piper, Uttam Babu Shrestha, Milica Pešić, Alexander Kagansky
Post-Biotics May Help Shield Obese From Diabetes
Gerald J. Joseph, B.S. M.Ed Health Coach
- April 20, 2017
- McMaster University
- It was previously thought that bacteria only caused problems such as higher inflammation and higher blood glucose. But this is only half of the story. Now researchers have discovered that a specific component of bacteria actually lowers blood glucose and allows insulin to work better during obesit
You’ve heard of pre-biotics and pro-biotics, but now you’ll be hearing a lot more about post-biotics. Researchers at McMaster University have begun to identify how post-biotics, or the by-products of bacteria, lower blood glucose and allow insulin to work better.
Jonathan Schertzer, assistant professor of biochemistry and biomedical sciences and senior author of a paper published by Cell Metabolism, explains it this way: “We know that gut bacteria, often called the microbiome, send inflammation signals that change how well insulin works to lower blood glucose.
“It was previously thought that bacteria only caused problems such as higher inflammation and higher blood glucose. But this is only half of the story. We discovered that a specific component of bacteria actually lowers blood glucose and allows insulin to work better during obesity.
“Understanding how different parts of bacteria control glucose could lead to new therapies that avoid some of the problems with pro-biotics or pre-biotics. We have found a “post-biotic” that lowers blood glucose during obesity.”
This work is important as more than half of Canadians are overweight or obese, which leads to higher levels of blood insulin and glucose. These features of prediabetes can lead to type 2 diabetes.
“But we haven’t understood what triggers elevated blood glucose,” said Schertzer. “This is significant because only some individuals with obesity develop prediabetes. Blood glucose is influenced by our genes, the food we eat, and the bacteria in our gut.”
His research team is working to develop new bacterial-based drugs to lower blood glucose and combat prediabetes before type 2 diabetes develops. At this time, they have had success in trials with mice with a drug currently used for osteosarcoma, a bone cancer.
In The End
Because the health of our gut is closely tied to many other bodily functions, prebiotics and probiotics together are important for battling inflammation and lowering overall disease risk.
Remember, that when it comes to supporting your microbiome and maintaining a healthy gut, keep your eye on the big picture. Eat a nutrient-dense high plant-food diet, limit or avoid processed foods, reduce grains, meat, fowl and dairy and consider other lifestyle changes that you can afford to make in order to better your health such as walking everyday and hydrating.
Gerald J. Joseph HealthCoach
- Joseph F. Cavallari, Morgan D. Fullerton, Brittany M. Duggan, Kevin P. Foley, Emmanuel Denou, Brennan K. Smith, Eric M. Desjardins, Brandyn D. Henriksbo, Kalvin J. Kim, Brian R. Tuinema, Jennifer C. Stearns, David Prescott, Philip Rosenstiel, Brian K. Coombes, Gregory R. Steinberg, Jonathan D. Schertzer. Muramyl Dipeptide-Based Postbiotics Mitigate Obesity-Induced Insulin Resistance via IRF4. Cell Metabolism, 2017; DOI: 10.1016/j.cmet.2017.03.021