Women s Wellness Day 2017

Transcription

1 Women s Wellness Day 2017 Precision Medicine The Latest Tests for Detecting Wellness Michael Palladino, ND Rowena Daly, ND Travis Nesbit, MD Ailin Barseghian El-Farra, MD

2 Functional Diagnostics for the Microbiome Michael Palladino, ND Naturopathic Resident

3 Father of Modern Medicine All Disease Begins in the Gut. - Hippocrates B.C.

4 2,400 Years Later Diseases Still Begin in the Gut

5 Digestive Diseases Vitamin & Mineral Deficiency Mood Disorders Chronic Stress Unhealthy Gut Skin Conditions Cardiovascular Disease Autoimmune Diseases

6 Workup History Symptoms Physical Exam Blood work Functional Diagnostics - Stool Test

7 Comprehensive Stool Test Overview Infection Inflammation Insufficiency Imbalance Diversity Association Relative Abundance Digestion Inflammation/Immunity Gut Microbiome

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9 Microbial Diversity

10 Microbiome

11 Treatment Considerations Diet that is low in refined carbohydrates and processed foods, rich in fiber, essential fatty acids, and phytonutrients, with a wide variety of fresh fruits, vegetables, and nuts. Antimicrobials for bacterial, fungal, or parasitic infections Abstinence from gut-damaging medications Probiotics, especially Lactobacilli and Bifidobacteria Prebiotics Increase stomach acid Nutritional deficiencies Physical exercise Fecal Microbiota Transplantation (FMT)

12 Women s Wellness Day 2017 Testing Methods for Adrenal & Reproductive Hormones cortisol cortisone dhea estrogen testosterone progesterone Rowena Daly, ND Naturopathic Resident

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14 Can we check my hormones? Cholesterol Blood sugar Cardiac function Thyroid function Liver & kidney health Intestinal health Sleep hygiene Mental/Emotional health Serum Saliva Urine

15 Bound vs. Bioavailable (free) Hormones Parking spaces = hormones Cars = binding proteins

16 Testing options: Serum Advantages Single collection Easy add-on Quick results Cost No required timeframe Diagnostic* Bound Disadvantages Snapshot data Requires lab visit Secretion/removal varies *Serum testing considered standard for clinical diagnoses

17 Testing options: Saliva Advantages At-home collection 24 hr data* Non-invasive Bioavailable Disadvantages Producing sample Multiple samples Prep/timing of collection Cost Turnaround time Lower concentration Functional *Some variability between labs

18 Testing options: Urine Advantages At-home collection 24hr data Non-invasive Bioavailable & Metabolites Rx monitoring Disadvantages Turnaround time Cost Multiple samples Prep/timing Functional

19 Testing options: Urine

20 Thank you

21 Women s Wellness Day 2017 Executive Health/Premier Health Program Travis Nesbit, MD

22 Living Longer Cardiac Stress Test Medically monitored Increasing speed and incline Achieve a high level of exertion FIT Score (next slide)

23 38% 11% 3% 2% FIT Exercise Treadmill Score

24 Carotid Ultrasound Radiation free Direct view of arteries Determine risk for stroke and heart attack

25 Central Blood Pressure Analysis How old are your arteries?

26 Living Stronger Functional Movement Screening

27 Living Healthier Body Composition Analysis Percent Body Fat Visceral Body Fat Muscle/Fat Balance Total Muscle Mass Hydration Status Basal Metabolic Rate

28 Women s Wellness Day 2017 How to Maintain a Healthy Heart Ailin Barseghian El-Farra, MD, FACC I May 5, 2017

29 Women and Heart Disease Heart disease and cancer are the 2 leading causes of death in US 1 in every 4 female deaths 64% of women who die suddenly of coronary artery disease had no prior symptoms Sidney S, et al. Recent trends in cardiovascular mortality in the United States and public heath goals. JAMA Cardiol. 2016;1(5):

30 Cardiovascular Disease (CVD) Mortality trends for males and females

31 Recent Trends in Cardiovascular Mortality in the US 3.98% 0.17% Age-Adjusted Mortality Rates in the United States, Rates shown for the total population and subgroups. JAMA Cardiol. 2016;1(5):594-9 Annual rate of decline for ALL CVD mortality for women

32 Traditional Risk Factors and Prevention of HEART Disease High blood pressure Manage Blood Pressure High LDL cholesterol Smoking Diabetes Overweight and obesity Poor diet Physical inactivity Excessive alcohol use Control Cholesterol Stop Smoking Reduce Blood Sugar Lose Weight Eat Better Get Active Limit Alcohol Manage Stress Life s Simple 7. Yusuf S et al. Lancet 2004;364-9

33 From Personalized to Precision Medicine Personalized Medicine Precision Medicine Clinical Risk Factors Family History Genomics/Lipidomics Mobile Device Data Modified from Prof. Geoffrey S. Pitt

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35 Cardiovascular Disease Prevention Tools: Atherosclerotic cardiovascular disease (ASCVD) Risk Estimator: 10-Year ASCVD Risk Lifetime ASCVD Risk Need: HDL Total Cholesterol Systolic Blood Pressure

36 Need: Cardiovascular Disease Prevention Tools: Health Assessment Total cholesterol Fasting Blood Sugar Systolic and Diastolic blood pressure Exercise Time (moderate and vigorous) Diet

37 Cardiovascular Disease Prevention Tools: Control Cholesterol Go beyond Basic cholesterol panel Boston Heart Diagnostics

38 EndoPat Endothelial Dysfunction 38

39 Cardiovascular Disease Prevention Tools: Imaging Coronary Calcium Score Carotid Intimal Thickening and Plaque

40 Lifestyle Modification Is the Cornerstone to HEART Health Diet Fruits and vegetables Two or more 3.5 ounce servings of fish per week Fiber-rich whole grains Less than 1,500 mg of sodium/day Limit added sugars or beverages Limit saturated fat <6% of total calories Mediterranean Diet lower risk by 30% Exercise At least 150 min per week (2 hours 30 mins) of moderate intensity exercise, or At least 75 min of vigorous activity per week Strengthen muscles and bones at least 2 days per week Heart rate goal: age 50-85% Manage Stress Mylifecheck.heart.org Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. New England Journal of Medicine, 2013

41 Change in Longevity (Years) Impact of Lifetime Activities on Longevity Adapted from Spielgelhalter D, BMJ 2012;345:e8223

42 Women s Wellness Day 2017 THANK YOU