The holidays are a time of feasting, but according to Dr. Mark Hyman, director of the Center for Functional Medicine at the Cleveland Clinic, our relationship with food is causing a health crisis.
He blames ‘chronic lifestyle diseases’ -- the accumulated effects of poor diet and lack of exercise – for about 80 percent of doctor visits and $1.3 trillion in annual healthcare costs.
In this week’s Exploradio, WKSU’s Jeff St.Clair talks with Hyman about his prescriptions for healthy living and using food as medicine.
We poke our heads into what looks like a conference room. It's called "The Harmony Room."
It’s one of the areas where Hyman and his team practice group medicine. He says eight to 12 patients share one medical appointment and are seen by a sequence of health coaches, nutritionists, doctors, and behavioral therapists.
"It’s really an extraordinary model that we’re looking to scale across all of Cleveland Clinic as a way to support all the institutes with their chronic disease patients. It’s very hard to create lifestyle change for people which is the driver of chronic disease, and this is a model that really helps to do that,” says Hyman.
But what is functional medicine?
“It’s what we all want – to function at our optimal level," says Hyman. "It’s the science of creating health."
"It’s a different way of thinking about disease based on causes and not just the symptoms.”
Conventional medicine, he says, labels a disease according to the symptoms, not the causes.
"So if you have depression, that is a diagnosis made by a list of symptoms; you’re sad, hopeless, helpless, no interest in sex, don’t want to eat, can’t sleep. You have depression.”
“But depression isn’t the cause of the symptoms, it’s the name of the symptoms," says Hyman, "and then we use an anti-depressant to suppress the symptoms."
"The question is, why are you depressed?”
Hyman says there's a long list of possible causes in this sample case:
"It could be that you’re eating gluten and you have a gluten sensitivity that causes an auto-immune disease called Hashimoto’s that gives you a low thyroid function. It could be because you’ve been taking an acid blocker like Prilosec for 10 years and have a B12 deficiency. Or because you don’t go outside in the winter and have a vitamin D deficiency. Or because you eat a lot of sushi and have mercury poisoning, or hate fish and have an omega-3 deficiency, or are taking antibiotics that destroy your gut flora, or have pre-diabetes because you eat too much Cinnabon."
"All cause depression," he says, "and conventional approaches don’t help us navigate to the root cause, whether it’s an auto-immune disease or diabetes, or dementia."
"Functional medicine," he adds, "is part of the emerging science of systems biology or systems medicine."
"The body is a network," he says. "It’s a biological network like an ecosystem. Some of our newer discoveries are breaking down these old concepts of the segregation of the body into these specialties.”
"If you go to the doctor and you have a rash and your joints hurt and you have stomach issues and you have a headache, you go to five different doctors. But it could be all those symptoms are related."
A conspiracy of bad food advice
Americans are among the most obese citizens in the world. And part of the reason for that, says Hyman, is the generations of bad advice we've gotten about what to eat.
“We have been guided down the wrong path by our own government and that has led to an enormous crisis in this country of obesity type-2 diabetes; one in two Americans has pre-diabetes or type-2 diabetes and a chronic disease. One in four children have pre-diabetes or type-2 diabetes. That didn’t exist before and now it’s common."
The food system has created an epidemic of chronic disease through the production of highly processed food, says Hyman.
Enormous amounts of sugar in our diet, for example, cause chronic illnesses like obesity, diabetes, and dementia, what is increasingly called 'type-3 diabetes.'
The USDA's dietary guidelines, says Hyman, were heavily influenced by the food industry and have led to really bad recommendations.
"Eleven servings of bread as a healthy diet doesn’t make any sense.”
Nutritional blind spot in medicine
The understanding of food as medicine is relatively new, says Hyman.
"Only 25 percent of medical schools have the minimum requirements of nutrition education," he says.
"Part of the blind spot in medicine is that we’ve ignored this huge category of substances in food that have huge ability to alter our biology. Nutrients in food affect your gene expression, they change your hormones, they change your immune system, they change your gut flora with every bite. They change your metabolism, they change literally everything in your body in real time all the time."
"When you use food as medicine you can have profound impacts on people," says Hyman.
"We get people off of insulin in a week," he says, "people who have chronic pain and arthritis."
"She was scheduled for knee replacements, and was overweight and fatigued, and [after the diet], everything went away and she cancelled the knee replacements. That’s something that could have cost our system $60,000 probably. With just changing her diet with a book that cost $6 on Amazon, she was able to cure herself without a doctor."
"That’s the power of food," says Hyman, "and I think most doctors don’t understand it because they never learned how to use food as a drug, and that’s what functional medicine is."