It’s the ecology stupid! What public health can learn from the battle to save the planet

By Jerome Burne

At the recent Health Optimisation Summit at Olympia, there was a feeling that a new type of medicine was being born. Its dimensions are complex, some parts are better defined than others but in packed lecture halls, common themes were running through the talks. 

Prevention was one, but not the anaemic ‘healthy balanced diet ‘version put out by official bodies for years. Instead, prevention or ‘optimisation’ is at the centre of this new medicine. Rather than focusing on disease, waiting until people start falling ill and then offering pills, the priority is to live in a way that keeps you well.

 As one speaker commented; ‘At the moment researchers study sick people – how effectively drugs can help control their symptoms or extend their lives? What they never study is people who are healthy to find out how they stay that way as they age. We are the missing data from their textbooks.’

This focus on optimising health forges a link between the new medicine and ecology. The planet is facing a growing crisis because we behave as if its resources are limitless. This has put sustainability centre stage – take care of the soil, the oceans, the air and maintaining a variety of species.

Medical silos not fit for purpose

We also need to pay attention to our own internal ecology and how best to sustain its complex interconnected networks, which are intimately engaged with the world around us via the quality of the air, the water and the soil.  

The current medical model is not attuned to the webs in the body that make up an ecological system. It is set up around silos of specialisation – heart, lungs, brain, hormones – with little attention to the multitude of ways they interact. The alarm bells sounding at the failure of this approach are all too familiar – sick elderly people on 6 or even 10 drugs, along with soaring rates of chronic diseases such as obesity, diabetes, Alzheimer’s and cancer. 

One of the speakers, Dr Robert Verkerk, along with his team at the Alliance for Natural Health has been focusing on this connection between the internal and external ecologies

 Along with others, he uses the idea of ‘terrain’ or ‘domains’ to describe key elements of our internal ecologies. They are the networks that handle vital processes such as control of blood sugar and insulin, getting rid of toxins, or keeping blood vessels flexible.’ 

Many of the domains interact via the microbiome in our guts which is one of the hubs of our internal ecology where the inner and outer worlds come together. Research is rapidly revealing what a wide range of processes it is involved in. Absorbing and using nutrients, fine-tuning immune responses and influencing how the brain handles stress and emotions. 

Monitoring your ecology network in real-time.

Another speaker, Dr Ted Achacorso, founder of the pioneering Health Optimization Medicine and Practice (HOMe/HOPe) described how it was possible to monitor the chemicals (metabolites) produced by the activity of these systems to measure how well they are functioning. 

 ‘This way we can get check the health of these domains in real-time and that allow us to predict what is likely to happen if changes aren’t made,’ he says. ‘We can see, for instance, how an excess of carbohydrates harms the energy-making units in every cell (mitochondria). 

‘Without a good energy supply, many of the vital systems won’t be carrying out such tasks as detoxifying the liver effectively. If that is not done, toxins persist, and other areas start to suffer.’ 

Another system that benefits from monitoring because poor functioning is likely to have big knock-on effects is the guts. Modern Western diets don’t create the wide variety of microbial species needed for the microbiome to flourish. This can raise the level of inflammation, which in turn is involved in all sorts of disorders around the body – in fat stores, the heart and the brain. 

Developing resilience and bounce

‘At the moment,’ says Dr Verkerk ‘the state of anyone’s terrain is pretty well ignored until symptoms develop that send you to the doctor. We need a Regenerative Health System, one that keeps us resilient and able to bounce back from stress or trauma. 

But the new medicine starts with lifestyle rather than sophisticated new monitoring technology. Verkerk advocates a new normal for health.  ‘We need to provide the right education and support so everyone can take part in managing their own health,’ he says. ‘Not relying on the doctors and pills.

‘Much of it involves very basic day-to-day things such as diet, physical activity, rest, relaxation and sleep. Once you know why they matter and that they allow you to deal with many health issues without pills, they become habits.’  

The new medicine is just emerging, with much to be sorted out, not least the name – metabolic, integrated, optimised? It’s got deep historical roots but also uses new technologies for measuring what is going on in the cell. Dr Achacorso uses sophisticated equipment to measure and track metabolite activity which he claims could give people in their 60’s a level of functioning that match those in their twenties. 

Measuring can tell you a lot but, Verkerk cautions, there are social and psychological factors that are vital for wellness, but which can’t be quantified, such as social connections and a feeling of meaning and purpose in life. 

Hidden pathways revealed

Another of the common threads running through the talks was the increased awareness of the effectiveness of diet, combined with various forms of fasting, for prevention and treatment. This has come with the widespread adoption of the low-carb and ketogenic diets. Not only have they proved a very promising treatment for weight loss and reversing diabetes, but they revealed key pathways – previously familiar only to biochemistry students.

 If you are new to these ideas, my recent book, The Hybrid Diet, written with nutritionist Patrick Holford, will bring you up to speed.  The heavy carbohydrate diet, eaten by many, pushes up blood sugar and insulin, which causes problems with weight and the arteries. Cutting carbs right down triggers the release of fat from storage, which is then turned into small dense compounds called ketones in the liver that can replace blood glucose as a source of fuel for the brain and muscles. 

 The game-changing effect of this process, part of the natural response to famine, is that it turns off one system that promotes growth (mTOR) and turns on one that cleans up the detritus that builds up in cells (autophagy). It also turns on a master switch (AMPK) – you do get used to the jargon! – which does a variety of useful things, such as tightening up a leaky gut and clearing fat from the liver – one of the damaging effects of excessive carbohydrate consumption.

A speaker who has been peering under the hood of our metabolic system and refining some of the ways that it can be manipulated is Dr Christopher Shade. His firm produces supplements that are particularly focused on removing toxins, reducing neuroinflammation and treating immune dysregulation. 

Oncologists waking up to the power of ecology

His talk described how these, and other tools, are now available to clinicians for terrain management.  Besides the lifestyle changes around diet, fasting, exercise and sleep, there is the use of various combinations of botanical supplements – green tea, ginger, curcumin, berberine, cinnamon, resveratrol and lipoic acid – that can, among other things, turn on ketone production.  

The ideas behind the new medicine have long been fiercely opposed by the cancer establishment; clinicians respond to questions about the likes of diet or supplements with indifference or hostility. The irony is that oncology is the medical discipline where the idea of an internal ecology is gaining the most traction. 

A couple of years ago top oncologist Professor Siddhartha Mukherjee wrote a ground-breaking article which suggested the field was failing patients by concentrating almost exclusively on cancer genes. (New Yorker Sept 11 2017: Cancer’s invasion equation) Instead, he suggested, oncologists should think of cancer as an invasive species, like Japanese knotweed in English gardens or rabbits in Australia. There was nothing in their genes that allowed them to spread wildly; back home they were well behaved. Something missing in the new environment made it possible. 

Patients must ask, Mukherjee wrote: ‘Not what cancer is doing to me, but what am I doing to the cancer?’  And the place to act to help keep cancer from spreading was in the terrain surrounding the tumour. Or, as he put it: ‘how to alter a susceptible patient’s immunological and histological profile to resemble that of a resistant one.’ That’s a good description of the effect the new medicine aims to have on disorders in general. 

 Dr Nasha (pronounced Naysha) Winters gave a hugely heartening talk about how to treat cancer by applying new medicine principles to enhance the body’s own invasion-beating abilities. She not only helps patients to develop a personal protocol but is becoming increasingly involved in teaching once-hostile oncologists how they can do it too. 

A new medicine pioneer; seeing off stage 4 cancer

She was diagnosed as being “riddled’ with ovarian cancer 28 years ago and is still alive to discuss it. Nothing but palliative care was on offer, so she set off on a personal journey, discovering, like other long-term, pioneering survivors, many of the routes to recovery that are now part of the new medicine but were then considered highly eccentric and almost certainly dangerous. 

She experimented with her diet – raw food, vegan and low carb combined with intermittent fasting. Very early she hit on the importance of the microbiome and its relationship with the immune system and the brain, something official oncology is only just catching up with. 

In fact, a few days before the conference, news outlets had reported the ‘surprising’ finding that a being prescribed a course of gut-microbe-destroying antibiotics before chemotherapy could reduce its effectiveness. Full details of her journey and what you can do now are in her best-seller ‘The Metabolic Approach to Cancer’.

The remedies she found were effective enough to allow her to start training as a regular doctor but as a result of her experiences, she switched courses to become a naturopath, which fitted more closely with the way she had come to think about cancer. In the States, naturopathy and mainstream training are much more closely aligned, so after graduating she practised regular medicine in hospitals for years.

The only plan B is not to be

For a long time, she has worked with patients who want to do more than follow the chemo, radiation, surgery route. After finding what they want, she then has a call, often via Skype, with their doctor about what they could do and why it makes sense. 

Do they take you seriously? ‘I’ve been running sessions training doctors as well for a few years now and what amazed me is that 80% of those who turn up are regular oncologists. That’s very encouraging because what I’m telling them is a big stretch: that cancer is a disorder of mitochondria (the energy-generating units in every cell) and that the starting point for prevention and treatment is to ensure all the domains in your internal terrain are working well.’ 

The changes involved in shifting to the new medicine are huge but like reshaping our economy to deal with climate change, Verkerk and the other clinicians believe we must do it because we can’t afford not to. 

Evidence will be a key part in promoting acceptance and Verkerk and his team are already running some real-world trials of this approach (see the website for more details). ‘The drive for it will have to come from patients in the grassroots and top-down from government and administrators trying to cut costs,’ says Verkerk. ‘Opposition will come from the big commercial players just as it is already is for the guys fighting climate change and aiming to turn around the neo-liberal economy. We can’t fail. The only plan B is not to be.’

Jerome Burne

Jerome Burne

Jerome Burne is the editor of HealthInsightUK. He is an award-winning journalist who has been specialising in medicine and health for the last 10 years and now works mainly for the Daily Mail. His most recent book “The Hybrid Diet” was written with nutritionist Patrick Holford, published 2018. Award: 2015: Finalist for 'Blogger of the Year' Medical Journalists' Association.

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