Nutrition at the Jefferson-Myrna Brind Center

Nutritional Interventions 

When using nutrition as a corrective intervention to aid healing or address a health problem, Edman relies on three primary approaches: (1) anti-inflammatory diets to reduce inflammation; (2) elimination or rotation diets for identifying food intolerance, food allergy, and food influence on disease; and (3) strategies that balance macronutrients for hypoglycemia, abnormal glucose tolerance, and insulin resistance.

Deciding which strategy to use is very individualized. For example, if a vegan or strict vegetarian diet is going to be successful, the patient needs to be highly motivated; otherwise they will fall off the regime. In the case of an arthritis patient who would like to try to wean himself off medications, an anti-inflammatory diet might help. But a vegan diet could be problematic for someone who is already underweight, as people tend to lose weight on that program. And although an effective glucose tolerance diet has been successfully used to improve the health of heart disease patients and metabolic syndrome patients, it would need to be combined with other dietary and integrative approaches to address neurological conditions.

“Rotation and elimination diets (rotating or avoiding patients' allergenic and/or problematic foods such as wheat, dairy, sugar, corn, soy, peanuts, gluten grains, alcohol, and caffeine) can be useful for stomach and intestinal disorders, migraines, autoimmune disorders, chronic inflammatory or pain disorders, skin conditions, and some allergies,” explains Edman, cautioning that the patient's ability and willingness to comply even for a short time is important to consider. He advises patients to “stock up” on the foods they can eat and remove the foods they can't so they are not tempted to revert to previous eating habits during this one- to two-week, or longer, trial dietary approach.

Abnormal glucose tolerance in underweight people and insulin resistance in overweight individuals are addressed in similar ways. Edman advises people with these health issues to limit or avoid sugars and refined carbohydrates; balance their meals for protein, healthy fat, and complex carbohydrates; limit caffeine; eat smaller, more frequent meals; and ingest specific nutrients such as magnesium and/or chromium.

Supplements 

In both remedial and wellness nutritional programs, Edman uses a range of supplements, including vitamins, minerals, fatty acids, amino acids, antioxidants, probiotics and prebiotics, herbs and botanicals, enzymes, hormones, glandulars, functional foods and food concentrates, and homeopathic remedies. But he is careful in not only what he suggests but also how much. “I don't like to overwhelm people,” he says. “So we start with one or two supplements beyond a foundation supplement approach of a multivitamin and mineral, fish oil, and a calcium/magnesium/vitamin D supplement and gauge their effect.”

“Supplements can benefit patients who make regular poor dietary choices, but variations in soil nutritional content, micronutrient losses from food processing and cooking, and genetic polymorphisms or variations in individual nutrient requirements also contribute to the value of supplementation,” he says. “As many as 50 genetic diseases and many genetic polymorphisms have shown improvement through a range of nutritional supplementation.”

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Daniel Monti, MD

The challenge is to target the optimal diet and supplement program that can produce the desired results but is not so difficult that the patient can't adhere to it. “This requires dialogue and understanding, as well as informational and practical support,” Edman says, adding that any guidelines should be recommended for a finite period of time. “For some, don't tell the patient no sugar,” he advises. “Say no sugar for two weeks.”

Intravenous Nutrition 

The Jefferson-Myrna Brind Center for Integrative Medicine is one of the few integrative medicine centers around the country that offers intravenous nutrition. “We see a lot of patients with chronic illness, such as cancer patients or people with intestinal issues. Oftentimes these people are not in a position to digest and assimilate food and other nutrients effectively, so using dietary interventions—food they need to eat or supplements they have to swallow—for this patient population isn't effective,” explains Daniel Monti MD, who serves as the executive director for the Center as well as its medical director. “But providing intravenous nutrition does work because it bypasses the gut, and the nutrients are assimilated directly into the blood stream.”

Monti explains that the procedure is no different than the intravenous tubes used in hospitals to deliver nutrients for patients, such as certain surgical patients, who can't eat. The Center orders its intravenous nutrients from the same pharmaceutical companies and compounding pharmacies that are used by the hospitals. “We are simply using basic nutrients to help those people with digestive challenges,” says Monti.

As appropriate, the Center also delivers the Meyers' Cocktail, an intravenous vitamin and mineral protocol developed in the 1970s by John Meyers, MD, at Johns Hopkins University in Baltimore, Maryland. The basic solution, which can be customized, contains magnesium chloride hexahydrate, calcium gluconate, pyridoxine hydrochloride, dexpantheno, vitamin B complex, and vitamin C. “We have successfully used the Meyers' Cocktail to Support patients with a variety of chronic illnesses,” explains Monti.

Although Monti hopes to initiate a formal research protocol for all of the Center's intravenous interventions, one very unique research study is already underway. Researchers from the Jefferson-Myrna Brind Center of Integrative Medicine in collaboration with scientists from Kimmel Cancer Center recently received approval from the National Institutes of Health to study the effect high-dose vitamin C has on non-Hodgkin's lymphoma patients. The researchers will look at whether high doses of vitamin C can slow the progression of this deadly disease.

“This is a unique study for a set of patients who have literally run out of options,” says Monti, the primary investigator for the study. “Vitamin C administered intravenously has shown great promise in the laboratory and there has been some anecdotal data in cancer patients. Vitamin C doesn't cost much and is very low in toxicity, making it a particularly desirable agent for further study.”

The study is based on recent basic science research conducted by the NIH, which demonstrated that when given in sufficient amounts intravenously, vitamin C converts to hydrogen peroxide. When the converted hydrogen peroxide was applied to certain non-Hodgkin's lymphoma cells in the laboratory, it killed the lymphoma cells but left the surrounding healthy cells intact.

“As leaders in the field of integrative medicine, Jefferson is always seeking new and innovative therapies for our patients,” says Monti. “We want to look in every corner for solutions. This study, our intravenous nutrient program, and our foundational nutrition program are all designed to give our patients the best care possible.”

For more information about the Jefferson-Myrna Brind Center of Integrative Medicine, please visit http://www.jeffersonhospital.org/cim/index.html.

Practicing partnership and integration 

At the joint meeting of the American Association of Naturopathic Physicians and the American Holistic Medical Association in Phoenix in August 2008, a groundbreaking panel composed of integrative healthcare organization leaders discussed collaboration, partnership, and integration.

Organized and moderated by Bill Benda, MD, the purpose of the panel was to stimulate conversation, and hopefully, eventual cooperation among the various organizations. Panelists submitted information in advance regarding the mission, vision, and specific outcomes of their organizations, as well as their strengths, weaknesses, and previous collaborative efforts. One interesting result of this informal survey was that many of the organizations shared the same mission.

Representing a broad range of practitioners and organizations, the following leaders participated as panelists:

Each panelist provided his or her perspective on healing of individuals, healing the healthcare system, and on how their organizations could better collaborate on major goals to improve clinical, educational, and research outcomes. Key questions posed included “What are the possibilities of what we can do together that we can't do alone?” and “What is it about me that prevents the change I'd like to see from happening?”

Some of the issues discussed were how to deal with turf battles and economic fears, the health freedom movement, supporting a national healthcare resolution, problems of professional elitism, addressing how global warming might affect health and healthcare, and the need for broadened definitions of health and healing.

The panelists, several organizational executive directors, and selected political and policy experts met for a working lunch afterward. Although it was premature for the group to commit to a new coalition, the panelists agreed to plan ongoing communications, present at future conferences, and continue to explore ways of working together. The panel's lunch discussion also brought forward the centrality of involving patients and students in activism for healthcare change.

“By joining voices with the army of patients, of students, and the broad range of practitioners we represent, a coherent case can be made for a broader focus on wellness promotion, on primary and secondary prevention, more safe and efficient chronic disease management,” said Dr Victor Sierpina.

Summarizing the discussions, the panelists agreed that this kind of collaborative approach is most likely the only way out of our overly expensive, disease-oriented, reactive healthcare nonsystem.

“Collaboration is on everyone's mind, but for most only in vague, general terms,” said Benda. “This suggests enormous potential for partnership should we honestly evaluate, compare, and contrast our strengths and limitations, and then consort with those who are experienced in arenas where we are not. We know we are on the same page—it is now time to begin writing a new reality based upon our communal principles and beliefs.”

UNM Center for Life Opens Its Doors 

The University of New Mexico (UNM) School of Medicine recently opened the doors to its new building for the Center for Life, an integrative and intercultural center for prevention and wellness. Inaugurated in 2008, the Center treats people with a wide range of health issues, using both ancient and modern medical techniques and emphasizing prevention and wellness along with disease management.

Under the direction of founder, and executive director, Arti Prasad, MD, the Center provides clinical services, medical education, research, and community service. The Center grew out of the medical school's Section on Integrative Medicine at the Health Science Center at UNM, which was established in 2001 by Paul Roth, MD, the EVP and the dean of the School of Medicine, and directed by Prasad, to develop a comprehensive primary healthcare system based on an integrative approach that combined allopathic medical care with complementary and alternative medicine using the best current evidence.

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The Center for Life reception area.

“Not only do we embrace Eastern and Western philosophies at this Center, but we try to integrate the traditions of New Mexico, such as Native American healing and Traditional Mexican healing such as curanderismo, as well,” explained Prasad.

The Center physicians work with a variety of healthcare providers—including doctors of Oriental medicine, nurses, hypnotherapists, psychologists, physical therapists, and massage therapists—to treat patients and help them achieve their health goals. The following healthcare services are offered at the new building:

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Arti Prasad, MD, with Paul Roth, MD.

For more information, visit the Center at 4700 Jefferson Blvd NE, Suite 100, Albuquerque NM 87109, telephone 505-925-7464, or visit the Web site at http://hsc.unm.edu/som/cfl.

Richard Cowling, III, Named Holistic Nurse of the Year 

Richard Cowling, III, MS, RN, PhD, was named 2008 Holistic Nurse of the Year by the American Holistic Nurses Association (AHNA). The Holistic Nurse of the Year award, the highest honor of AHNA, is presented annually to recognize outstanding achievement in the field of holistic nursing.

Cowling is the editor of the Journal of Holistic Nursing, and professor and director of the PhD program in nursing at the University of North Carolina at Greensboro. Certified as an advanced practice nurse in both mental health and holistic nursing, Cowling has served as an educator, researcher, administrator, and practitioner in universities in Virginia, Ohio, South Carolina, and North Carolina. His research and scholarship is focused on facilitating the personal power of women who have survived child abuse.

“Richard Cowling is the first male winner of this award,” said Jeanne Crawford, MA, MPH, and executive director of AHNA. “What a fantastic choice.”

Founded in 1981, AHNA is a nonprofit membership association for nurses and other holistic healthcare professionals, with headquarters in Flagstaff, Arizona. Holistic nursing is recognized by the American Nurses Association as an official nursing specialty with defined scope and standards of practice. For more information please visit the Web site at http://www.ahna.org.