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The Gathering Storm; The Breaking Dawn - Newport Beach, CA

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In this lecture, presented February 8, 2014, Dr. Cady reviews the current state of medical economics in the US, highlighting both dangers as well as opportunities to improve American's health. He ...

In this lecture, presented February 8, 2014, Dr. Cady reviews the current state of medical economics in the US, highlighting both dangers as well as opportunities to improve American's health. He also reviews the Pharmanex BioPhotonic Scanner, the science of antioxidants and carotenoids, and the advantages of supplementation with a balanced multivitamin and multimineral supplement with fish oil. Numerous studies are cited correlating optimal nutrition and supplementation with normalization/optimization of thyroid function, blood sugar, brain function, minimization of brain shrinkage and cognitive decline, and avoidance of sexual dysfunction.

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  • First thing politicians have to do is serve their constiuents – to “maintain the current perceived benefit of the structure.” <br /> Next priority is taxes – “You will protect your constituency.” Republicans want tax cuts for everybody. Democrats – protecting their constituency. “Tax the rich” Both see the same problems. Their solution is different. <br /> Next, doctors will fight with the hospitals and organizations for reimbursements. <br />
  • This represents a disconnect between the AMA and physicians. <br />
  • In the 1960’s and 1970’s – when it was known that someone’s child was becoming a doctor, it was viewed as a great accomplishment. <br />
  • Speaker note – transition– of tale of three women. <br />
  • FROM WIKIPEDIA - Epidermis <br /> Epidermis, "epi" coming from the Greek meaning "over" or "upon", is the outermost layer of the skin. It forms the waterproof, protective wrap over the body&apos;s surface and is made up of stratified squamous epithelium with an underlying basal lamina. <br /> The epidermis contains no blood vessels, and cells in the deepest layers are nourished by diffusion from blood capillaries extending to the upper layers of the dermis. The main type of cells which make up the epidermis are Merkel cells, keratinocytes, with melanocytes and Langerhans cells also present. The epidermis can be further subdivided into the following strata (beginning with the outermost layer): corneum, lucidum (only in palms of hands and bottoms of feet), granulosum, spinosum, basale. Cells are formed through mitosis at the basale layer. The daughter cells (see cell division) move up the strata changing shape and composition as they die due to isolation from their blood source. The cytoplasm is released and the protein keratin is inserted. They eventually reach the corneum and slough off (desquamation). This process is called keratinization and takes place within about 27 days. This keratinized layer of skin is responsible for keeping water in the body and keeping other harmful chemicals and pathogens out, making skin a natural barrier to infection. From WIKIpedia <br />
  • How many people here were scanned on this unit? <br /> How many by me? <br />
  • Easy non invasive personalized validated <br />
  • METHODS: <br /> In the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg), which was recruited in 1994-1998, 23,943 participants without pre-existing cancer and myocardial infarction/stroke at baseline were included in the analyses. Vitamin/mineral supplementation was assessed at baseline and during follow-up. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). <br /> RESULTS: <br /> After an average follow-up time of 11 years, 1,101 deaths were documented (cancer deaths = 513 and cardiovascular deaths = 264). After adjustment for potential confounders, neither any vitamin/mineral supplementation nor multivitamin supplementation at baseline was statistically significantly associated with cancer, cardiovascular, or all-cause mortality. However, baseline users of antioxidant vitamin supplements had a significantly reduced risk of cancer mortality (HR: 0.52; 95% CI: 0.28, 0.97) and all-cause mortality (HR: 0.58; 95% CI: 0.38, 0.88). In comparison with never users, baseline non-users who started taking vitamin/mineral supplements during follow-up had significantly increased risks of cancer mortality (HR: 1.74; 95% CI: 1.09, 2.77) and all-cause mortality (HR: 1.58; 95% CI: 1.17, 2.14). <br /> CONCLUSIONS: <br /> Based on limited numbers of users and cases, this cohort study suggests that supplementation of antioxidant vitamins might possibly reduce cancer and all-cause mortality. The significantly increased risks of cancer and all-cause mortality among baseline non-users who started taking supplements during follow-up may suggest a "sick-user effect," which researchers should be cautious of in future observational studies. <br />
  • When repleted - results pretty quickly. “If if spasms, think magnesium” – bowel, bronchial. <br />
  • “About 80% of your genetic material is made up not of genes but of gene switches (which we are just beginning to understand). These switches cause changes in the way a gene works; this is called Gene Expression” <br />
  • This heatmap illustrates gene expression of three groups from a pre-clinical test with one of the ageLOC Vitality ingredients: young (column 1), old (column 2), and old with ageLOC science (column 3). Each row represents one of 52 genes comprising the mitochondrial Youth Gene Cluster (mtYGC). Columns 1 and 2 show that each of the 52 genes became more or less active during the aging process. In column 3, the YGC activity pattern of the old with ageLOC science group has been reset to a gene expression pattern similar to the young group in column 1.1 <br />
  • From the study: We and others have previously hypothesized that defects in mitochondrial oxidative and phosphorylation capacity might be a contributing factor to the increased triglyceride content in muscle and the liver. To test this hypothesis, we assessed in vivo rates of mitochondrial oxidative activity in skeletal muscle by 13C NMR and phosphorylation activity by 31P NMR. Using this approach, we found that rates of mitochondrial oxidative and phosphorylation activity were both reduced by ~40% in the elderly participants as compared with the young controls. <br />

The Gathering Storm; The Breaking Dawn - Newport Beach, CA Presentation Transcript

  • 1. The Gathering Storm, The Breaking Dawn: New Challenges & Opportunity for the Health of America Louis B. Cady, MD – CEO & Founder – Cady Wellness Institute Adjunct Clinical Lecturer – University of Southern Indiana Adjunct Clinical Lecturer – Indiana University School of Medicine Department of Psychiatry Child, Adolescent, Adult & Forensic Psychiatry – Evansville, Indiana
  • 2. Disaster awaits. “If some real disaster impends in the city, it is not because parking spaces are hard to find, because architecture is bad, because department store sales are declining, or even If there is a genuine crisis, it has to do with the essential welfare of individuals or with the good health of the society, not merely with comfort, convenience, because taxes are rising. amenity, and business advantage, important as these are.” from The Unheavenly City, Edward C. Banfield, 1968, 1970
  • 3. www.slideshare.net/lcadymd
  • 4. Here it is again… :) www.slideshare.net/lcadymd
  • 5. Learning objectives • Define a problem: America is unhealthy, and the middle class is shrinking. • Explore the tautomerism between medical economics & availability of care. • Answer the question of “but I just don’t GET it about those antioxidants.” • Answer the objections about the scanner “gizmo.” • Review the literature. Achieve state of the art, up to date knowledge. • Review some personal reflections.
  • 6. The health of society & the doctors to treat it And why we should all start paying attention to those “filthy rich doctors” and how they are getting paid. • America’s health is declining. • Doctors are going to get squeezed: more will quit, YOUR out of pocket costs are going up. • Americans will have less money to pay for bigger health care costs • Average people need to do something NOW to maintain health and minimize costs.
  • 7. The Problems & The Solution The good ole days: •People had jobs •People had insurance •Insurance PAID. •Society was healthier. •Doctors were plentiful. •Your healthcare was essentially “free,” no matter how stupidly you behaved. Problems: •2001/2008 recessions •Outsourcing •More medical technology •More activism from groups such that “everything must be covered.” •More government interference in free market The RESULTS: •Medical insurance costs more $$$. •Fewer doctors available. • Doctors are quitting. • Insurance companies/ government = defacto RATIONING. •Now, you “gonna have to PAY” for poor health habits, poor nutrition, obesity, smoking, etc.
  • 8. Everett Napier, an unemployed miner, said he pawned various items while he has been looking for work, including rifles, tools, jewelry and two guitars he used to play at church. 'I just swallowed my pride and quit playing. That's all you can do.' David Stephenson for The Wall Street Journal. November 26, 2013
  • 9. “Excess body weight is correlated with excess morbidity and mortality. In particular, Grade 2 or higher obesity (BMI>35) significantly increases the risk of death.” (c) 2013 Louis B. Cady, M.D. - all (www.cdc.gov/nchs/data/hus/hus11_InBrief.pdf) rights reserved
  • 10. “F as in Fat – How Obesity Threatens America’s Future 2012” – Robert Wood Johnson foundation Current and future IN obesity rates: 2011 – 25 % 2030 – 49.5% (if BMI reduced 5%) 2030 – 56% http://healthyamericans.org/report/100/
  • 11. ECONOMY ISSUES
  • 12. February 2, 2004
  • 13. www.billfoster.com - Reviving American Manufacturing, accessed 1 27 2014 www.billfoster.com - Reviving American Manufacturing, accessed 1 27 2014
  • 14. http://www.scdigest.com/assets/newsViews/08-06-12-2.php accessed 01 27 2014 http://www.scdigest.com/assets/newsViews/08-06-12-2.php accessed 01 27 2014
  • 15. Look out Pharma reps!!
  • 16. Unemployment, underemployment are contemporary problems…
  • 17. Feb 6, 2014 - The “SGR” cut: 24 – 30% of Medicare fees - Has been “patched” 15 times since 2002 for c. $140 billion - Additional source: McDonough J.E. “Health Stew” column 12/22/2013 http://www.boston.com/lifestyle/health/health_stew/2013/12/advice_to_congress_pass_sgr_ accessed 2/7/2014
  • 18. Business 101 – 3 doctor internal medicine clinic INCOME NET Revenue: $1.5 million Income less expenses = ZERO. This balances. EXPENSES: Overhead* : $1 million [support staff salaries, rent, depreciation, malpractice insurance, license fees, “MOC” fees, equipment costs, consumables, cleaning, office supplies, facilities insurance, Workman’s comp, retirement plans for staff and docs, CME, vacation pay, sick pay, insurance plans for staff and docs] Salaries – 3 docs: $500K Total expenses: $1.5 million
  • 19. Business 101 – 3 doctor internal medicine clinic INCOME (prev) Revenue: $1.5 million Less 24% cut: - $360,000 Total income EXPENSES: Overhead* : $1 million [support staff salaries, rent, depreciation, malpractice insurance, license fees, “MOC” fees, equipment costs, consumables, cleaning, office supplies, facilities insurance, Workman’s now:$1,140,000 comp, retirement plans for staff and docs, CME, vacation pay, sick pay, insurance plans for staff and docs] Income less expenses = ZERO. This balances. Salaries – for 3 docs = 46,667 per doc (What’s left over for salaries: $140,000) Total expenses: $1.14 million
  • 20. Instant replay • 24% cut to gross receipts • 72% cut to doc salaries (from $166,667 down to $46,667 – Working 50 – 60 hours per week – Hassled by paperwork, Medicare reviewers, prior authorizations, constant threat of malpractice lawsuits, continued baseline 2% inflation per year and no way to make it up. • WHAT WOULD YOU DO???
  • 21. Medicare patients – you’re safe for now. So far.
  • 22. Likely developments in healthcare, from Tyler Cowen, Average Is Over • “Just as some poorer people will do without fancy infrastructure, so will others do without advanced health care.” • “Since we won't be willing to pay for full-benefit Medicare and Medicaid for everyone who will need it, some people will see cut benefits or rationed access to doctors. Our political system will try to construct that rationing so that voters blame the doctors rather than the politicians, but one way or another rationing will increase.”
  • 23. One solution to higher costs for medical care if you’re an insurer: fire your doctors so people can’t get to’em. Connecticut: United Health Group cuts 2,250 physicians (810 primary care, 1,440 specialists) from its “Medical Advantage” network
  • 24. Another solution to financial outflows from private insurers and Medicaid/Medic are: close hospitals & “reduce beds” so you’re not losing money.
  • 25. Heck, let’s run out of saline while we’re at it.
  • 26. “The United States is expected to have a shortfall of nearly 160,000 physicians by 2025 – even as allopathic medical schools have increased their class sizes by 30 percent.”
  • 27. Just because a patient says “I’m insured” and has a card, doesn’t mean that the doc will be paid.
  • 28. 1. Repeal of SGR 2. Jan 1 2014 – “full” Affordable Care Act implementation 3. October 1, 2014 – ICD-10 required. 4. “Meaningful use” demanded of EHR’s – to which physicians must attest by Sept 30. 5. Physician data to be published by Sept 30 under “Sunshine Act.”
  • 29. Spokesman for Centers for Medicare and Medicaid Services: the agency was “committed to implementing I.C.D.-10 on Oct. 1, 2014, and that will not change.” “If you don’t code properly, you don’t get paid.” – W Jeff Terry, MD – Mobile, “If you don’t code properly, you don’t get paid.” – W Jeff Terry, MD – Mobile, ALA. ALA.
  • 30. “Sunshine” in Colorado
  • 31. What are the results of these pressures?
  • 32. As payments shrink, and overheads rise, docs are looking for more income December 17, 2013
  • 33. Doctors quitting medicine • Suicide* (2004): – 1.41 X for male physicians vs. general pop. • "Half of primary care physicians in survey would leave medicine ... if they had an alternative." -- CNN, November 2008 * Schernhammer ES, Coldit GZ. Am J Psychiatry. 2004 Dec; 161 (12):2295-302 .
  • 34. REASON: “EHR” requirements. “Would cost too much in his small medical practice.”
  • 35. 7,288 physician responses 45.8% of physicians had at least ONE symptom of burnout CONCLUSIONS: “Burnout is more common among physicians than other US workers.”
  • 36. Medscape Compensation Report – Would you choose medicine as a career? • 2011 • 2012 • 2013 • 2014 69% 54% ? ?
  • 37. “Why I Left Medicine: A Burnt-Out Doctor’s Decision to Quit”* • “It may be dramatic and self-serving to frame my career change as a way to avoid suicide, but I can attest that medicine was not conducive to my health.” http://commonhealth.wbur.org/2013/10/why-i-left-medicine-a-burnt-out date 10/18/2013 – accessed 01/07/2014
  • 38. Clinical details • I suffered from early morning wakening, even on my weekends off. • I had trouble leaving my work at work. I’d go for a run and spent the entire 30 minutes wondering if I’d ordered the right diagnostic test. • I startled easily. • I found it impossible to relax. • I worried constantly that I’d make a mistake. • I no longer remembered the joy I’d felt when I first began medical school, • And I couldn’t imagine surviving life as a doctor.” http://commonhealth.wbur.org/2013/10/why-i-left-medicine-a-burnt-out date 10/18/2013 – accessed 01/07/2014
  • 39. The Future of Medicare “Medicare is going bankrupt. The Medicare Trustees estimate that the program will run short of money starting in 2017.” •Rep. Bobby Scott, Senators Jim Webb and Mark Warner http://www.congress.org/congressorg/bio/userletter/? id=3181&letter_id=4747883751. Accessed April 3, 2010. Slide courtesy of John Adams, MBA – CEO, Cenegenics
  • 40. Healthcare Reform–Physicians Perception of Medicine Over the Next Few Years http://www.athenahealth.com/index.php?open=26. Accessed April 3, 2010. Slide courtesy of John Adams, MBA – CEO, Cenegenics
  • 41. Are the Best and Brightest Staying in Medicine? “60% of physicians would not recommend medicine as a career to their children.” http://www.mayorswellnesscampaign.org/wpcontent/uploads/2009/05/merritt-hawkins-survey.pdf. Accessed April 3, 2010. • – The Physicians’ Foundation Slide courtesy of John Adams, MBA – CEO, Cenegenics
  • 42. “But I’m not a doctor; I’m not going to have those problems.” • Dentists, optometrists – mixed fee for service model (at present) and insurance. • EVERYONE will be having higher deductibles (and be cash strapped). – Manifestations: deferred maintenance (Mercedes) • If hospitals, or clinics close, service providers connected with it will lose their jobs. • If you are a cosmetologist or server – declining business, declining tips
  • 43. For doctors and society at large… What are the solutions?
  • 44. Background for this section: • There are no “drug claims” made for any products from NuSkin/Pharmanex • No NuSkin/Pharmanex product– nor any other “OTC” vitamin or supplement – is designed to treat, prevent, mitigate, diagnose or do anything else to or for any disease. • Pharmanex nutritional supplements & weight control products are designed to support the structure and function of the human body. (c) 2013 Louis B. Cady, M.D. - all rights reserved
  • 45. Scientific portion:Learning objectives • Importance of antioxidants (with refs) • “It’s not about the antioxidants.” • Origins and validity of the Biophotonic Scanner • The critical “three points” of the “Cady White Paper” • AgeLOC technology and “YGC’s” (??) • Vitality and TR90
  • 46. Cady Wellness Institute – July 2005 The Reasons: • • • • Conventional medical practice had failed me twice. A lot of “psychiatric cases” WEREN’T “psychiatric.” Nobody was integrated. Nobody was looking at ALL of the peer-reviewed literature.
  • 47. Evansville Courier & Press: May 29, 2006
  • 48. As of 2/7/2014 (104 more than in November 2013)
  • 49. As of 2/7/2014 (72 more than in November 2013)
  • 50. Could it happen to you?
  • 51. What causes oxidative stress? • Environmental Toxins – – – – Heavy metals – including Mercury (fillings!) Pesticides/herbicides Preservatives PCB’s, Dioxins, Phthalates • Toxins produced in the body – Yeast and bacteria – Products of cellular metabolism • Emotional Stress – Anxiety/Tension – Fear – Anger
  • 52. Oxidative stress in the BRAIN – why you should “know your numbers”
  • 53. Why is the brain so susceptible to oxidative stress? • Burns glucose – generates free radicals. • Uses 20% of total oxygen and energy consumed by the body. • ½ of this is for electrochemical nerve transmission. • Contains IRON • Contains essential fatty acids, which can be OXIDIZED (“rancid fat”) • Limited supply of own antioxidants • Limited ability to regenerate/repair damage
  • 54. • • • • What are some consequences of oxidative stress? Behavioral deterioration Impaired cognitive function Decreased memory Psychiatric symptoms • Increased inflammation • Depressed immune system • DNA damage • cancer
  • 55. 13,474 as of 2/7/2014
  • 56. - 27,000,000,000,000,000 (27 TRILLION) pounds of chemicals produced in or imported to US, each year. - Amer. Acad. Of Pediatrics – note “thousands of chemicals” children are exposed to daily.
  • 57. Age-related changes in total blood mercury levels for females 16 – 49 years of age, 1996-2006. Source: 4th National Report on Human Exposure to Environmental Chemicals. CDC 2009.
  • 58. “The results show that America’s pets are serving as involuntary sentinels of the widespread chemical contamination that scientists increasingly link to a growing array of health problems across a wide range of animals – wild, domesticated, and HUMAN.” (c) 2013 Louis B. Cady, M.D. - all Nadenko,O et al. High levels of toxic industrial chemicals contaminate cats and dogs. rights reserved April 2008. Environmental Working Group. www.ewg.org/reports/pets - accessed 2/13/2013
  • 59. Environmental working group (baby) cord blood study - 2009 • 10 minority newborns from five states – tests were for > 300 chemical sat a cost of $10,000 per baby. Two year study (2007 – 2008) • 232 toxic chemicals found – Bisphenol A (estrogen like chemical in plastics – linked to early puberty & childhood obesity, neuro and behavioral changes (found in 9/10 babies) • Aggression in little girls • Sexual problems in men – Tetrabromobisphenol A (toxic flame retardant for computer circuit boards) – Perfluorobutanoic acid (Teflon family – for non-stick cooking) Ref: http://www.mnn.com/health/fitness-well-being/blogs/232-toxic-chemicals-found-in-10-newborns (c) 2013 Louis B. Cady, M.D. - all rights reserved
  • 60. 1976 – 2009 METASTATIC breast cancer: - Compounded increase of 2.07% per year over 34 year period (c) 2013 Louis B. Cady, M.D. - all rights reserved
  • 61. One more time… no supplement, under the DSHEA act, may be represented to treat, cure, mitigate or prevent any disease. No such “health claims” are being advanced for any Pharmanex/NuSkin supplement or product. The following slides represents a LITERATURE REVIEW It correlates antioxidants, carotenoids and various conditions described in the peer reviewed medical literature. - Louis B. Cady, MD On February 8th, 2013 More data: a mad dash through the literature
  • 62. Note: these citations are searched under “carotenoids with _____” and “antioxidant(s) with _____.” Other relevant search terms are “oxidative stress with ____” and “nutrient deficiency with ____.”
  • 63. Antioxidant assessment Reference: www.cadywellness.com/cadyw
  • 64. Center for Biomedical Optics – Dixon Laser Institute, University of Utah • Werner Gellermann, Ph.D. – Research Professor • Colleague – Igor Ermakov, Ph.D., et al. • Technologies – “Novel Raman Spectroscopy and Raman Imaging.” • Funding: – National Institutes of Health – State of Utah – Spectrotek, LLC
  • 65. “A method and apparatus are provided for the determination of levels of carotenoids and similar chemical compounds in biological tissue such as living skin.”
  • 66. Dissolved carotenoids in stratum corneum 27 days
  • 67. “Results obtained… have shown that carotenoids are vital components of the antioxidative protective system of the human skin and could serve as marker substances for overall antioxidative status.”
  • 68. (c) 2013 Louis B. Cady, M.D. - all rights reserved
  • 69. The Biophotonic Scanner – the first of the IP – protected breakthrough NSE/Pharmanex technologies
  • 70. First “Portable” BioPhotonic Scanner 2002
  • 71. The Scanner - revised • Journal of Biomedical Optics, July/Aug 2008 – Peer-reviewed scientific journal
  • 72. “RS accurately measures total carotenoids in human skin with less intra-individual variability than measurement of serum carotenoids by HPLC analysis. RS technology is a valid and reliable noninvasive method to rapidly assess carotenoid nutritional status in humans.” (J Am. Coll Nutr 2009)
  • 73. Scientific Validation: Peer-reviewed by the medical & research communities • Society of Investigative Dermatology, May 25, 2000. – Non-Invasive Raman Spectroscopic Detection of Carotenoids in Human Skin. • Arch Biochem Biophys. 2010 Dec 1;504(1):40-9. Epub 2010 Aug 1. – Validation model for Raman based skin carotenoid detection • J Eur Acad Dermatol Ven. 2011 Aug;25(8):945-9. – Skin carotenoid levels in adult patients with psoriasis.
  • 74. “RSS spectroscopy is a reliable method for non-invasive measurement of B-carotene levels in skin, and may be used as an important biomarker of antioxidant status in nutritional and health studies in humans.” Ramirez-Velez, et al. Endocrinol Nutr. 2012 April
  • 75. “But is the scanner really valid and dependable?”
  • 76. • “The totality of the evidence supports the use of skin carotenoid status as an objective biomarker of fruits/vegetable intake…” • “..skin carotenoids may effectively serve as an integrated biomarker of health…” • “Thus, this biomarker holds promise as both a health biomarker and an objective indicator of fruits & vegetables intake….”
  • 77. Scamo S et al. Br J Nutr. 2013 Sep 14;110(5):911-7. • Good agreement between single and multiple measures (95% CI) • + association with intake of total carotenoids • “A single RRS measure was reasonably accurate at classifying usual skin carotenoid state.”
  • 78. So where do I find this “white paper”? • www.google.com • www.cadywellness.com/ cadywhitepaper2008.pdf
  • 79. What’s up with these caretenoids? Or… “The Cady White Paper in 3 slides”
  • 80. Relationships of carotenoids to other more conventionally measured antioxidants (p 6 -7) • Svilaas et al (2004): – 2, 670 adults studied with serum carotenoids measured and correlated with vitamin consumption – serum carotenoids were stronger predictors of other antioxidants than were alpha, beta, delta, and gamma tocopherols, as well as glutathione.* * Svilaas A, et al. Intakes of antioxidants in coffee, wine, and vegetables are correlated with plasma carotenoids in humans. J Nutr. 2004 Mar;134(3):562-7.
  • 81. Convenience of carotenoids as antioxidant measurement (pp7-11) • Hata, et al* (2000) – correlated skin carotenoids (Raman) with carotenoid levels from skin from abdominoplasty patients (HPLC). • “Our technique can be used…for assessing antioxidant status and the risk for diseases related to oxidative stress.” [Palm of skin = highest carotenoid location] *Hata et al. Non-invasive Raman spectroscopic detection of carotenoids in human skin. J Invest Dermatol. 2000 Sep; 115(3):441-8.
  • 82. The Svilaas/Hata Syllogism: • Hata (2000) – Raman measurements of carotenoid == HPLC skin measurements • Svilaas (2004) – skin carotenoids = better predictor of antioxidant status than mixed tocopherols and glutathione • THEREFORE [Cady]: Raman spectroscopy is a better measure of antioxidant status than mixed tocopherols and glutathione.
  • 83. BTW – what does that “SCS” actually mean in REAL LAB MEASUREMENTS? • Y = 12703 * X + 5891.7 – Where Y is the SCS, and X is the carotenoid concentration in MICROgrams/ml, viz: • • • • • 25,000 = 12703X + 5891.7 25,000 – 5891.7 = 12703 * X 19,108.3 = 12703 * X 19,108.3 /12703 = X X = 1.50 MICROgrams /ml • Rule of thumb: 1,000 on SCS = .06 ug carotenoid/ml blood serum • (e.g., SCS of 40,000 = 2.4 ug carotenoid/ml) Source: NuSkin/Pharmanex
  • 84. “You don’t need vitamins: (a) you can get’em in your food; (b)they just make expensive urine.” “I don’t believe in antioxidants.” – from an MD!!
  • 85. 16,103 people – 1994 – 1996. ZERO got 100% of all required vitamins and nutrients - Highest – B12 =- 82.8% got enough - 66.8% - had adequate folate - Lowest – Zinc – only 26.6% got enough.
  • 86. Epidemiology of Vascular Aging (EVA)
  • 87. Epidemiology of Vascular Aging (EVA) • Study population: – N=1,389; age range {59-71 yoa} – 9 year study • Relative risks: – all cause mortality at 2.94X in men in lowest quintile (95% CI, P=0.03) – cancer 1.72X in men (95% CI, P=0.01 • “Total plasma carotenoids levels were independently associated with mortality risk in men.”
  • 88. Vitamin/mineral supplementation & cancer, cardiovascular, and all-cause mortality (EPIC-Heidelberg) Li K, Kaaks R., et al. Eur J Nutri July 2011 • Purpose: evaluate vitamin/mineral supplementation with CA, CV dz, and mortality • Methods: – 23,943 healthy participants, followed 11 years – Baseline and “new-use” supplementation noted • Results: 513 CA deaths, 264 CV deaths – “No MVI supplement had any significant effect” • “sick user” phenomenon discussed. • Baseline users of antioxidant supplements had significantly reduced risk of cancer [HR 0.52] and all cause mortality [0.58]
  • 89. Antioxidants and brain tumors? • “free radicals are another etiological factor of brain tumor and are removed by cellular antioxidants in the human body.” • Inverse correlation between: – antioxidant levels and oxidative DNA damage – Grades of malignancy • Decrease in antioxidants are associated with severity of malignancy
  • 90. Conclusions • “It is concluded that administration of antioxidants could reduce the incidence of brain tumors and probably other types of cancer.” • - Shewelta SA , Sheikh, BY Curr Drug Metab. 2011 Jul;12(6):587-93. (Dept.of Biosciences & Technology, Alexandria University, Egypt.)
  • 91. Can you relax with an 81,000 scan score??
  • 92. Total organic fruits/vegetables intake, 9 – 12 servings per day. No supplements.
  • 93. 74,000
  • 94. The train has left the station…
  • 95. what about other things besides carotenoids and “Antioxidants”?? Or… why can’t you just “juice” your way to complete and optimal health???
  • 96. Seismic shift in the medical literature - 2002 “Pending strong evidence …from randomized trials, it appears prudent for all adults to take vitamin supplements.” Fletcher & Fairfield, JAMA 2002
  • 97. “Inadequate intakes may result in chronic metabolic disruption, including mitochondrial decay.” “[They] cause DNA damage, such as chromosome breaks, in cultured human cells or in vivo.” “triage theory
  • 98. The Physicians’ Health Study II • Take a multivitamin! CONCLUSIONS: “Daily multivitamin supplementation modestly* but significantly reduced the risk of total cancer.” * Note – “Centrum Silver” was used.
  • 99. http://cadywellness.com/do-vitamins-work-two-recent-studies-say-no-sh accessed 2/8/2014
  • 100. http://www.lef.org/featured-articles/Federally-Funded-Analysis-Attemptsaccessed 2/8/2014
  • 101. How to lie in your vitamin studies • Use sub-optimal doses • Use sub-optimal doses and use just one or two ingredients. (not a SYSTEM) • Use excessively high doses (and give side effects) • Use SYNTHETIC vitamins at toxic doses • Give’em too late • Conflate correlation with causation • Use skewed (fake) placebo group • Don’t monitor for compliance
  • 102. Essential Fatty Acids – relevant for: “Psych” “Medical” • • • • • • • Seizures • Rheumatoid arthritis (& anything with inflammation) • Coronary heart disease (or health maintenance) Depression Bipolar depression Schizophrenia Autism AD(H)D Learning disabilities
  • 103. Do YOU Need Fish Oil? 5X reduction
  • 104. Symptoms of B12 Deficiency Mental • • • • • • • • • Irritability Apathy Personality changes Depression Memory loss Dementia Hallucinations Violent behavior Anxiety Physical • Diminished sense of touch and pain • Clumsiness • Weakness • Pernicious anemia • Chronic fatigue • Tremors • GI problems
  • 105. LifePak Nano - % RDA in 2 packets • B12 1,000% (as 60 MICROgrams cyanocobalamin) • B6 500% • Folic acid/folate - 150% • Magnesium 76% (as 300 Mg amino acid chelate) • Zinc 100% (15 mg as zinc chelate) • Selenium 200% (L-selenomethionine & NaSeO3) • Iodine 76% • Chromium 166% • Vitamin C 834% • Vitamin A 300% (83% as Beta carotene and plant extracts)
  • 106. Your brain and B12 • If you are in the bottom 1/3rd for B-12 levels…. • SIX TIMES increase risk of brain volume loss (Odds ratio = 6.17, 95% CI) – Vogiatzoglou A et al. Vitamin B12 status and rate of brain volume loss in community-dwellers. Neurology. 2008 Sep 9;71(11):826-32. – (107 volunteers aged 61-87 years of age)
  • 107. BRAIN SHRINKAGE… CONCLUSIONS: “The accelerated rate of brain atrophy in elderly with MCI can be slowed by treatment with homocysteine-lowering Bvitamins.” Smith AD, Smith SM, de Jager CA, Whitbread P, et al. (2010) Homocysteine-Lowering by B Vitamins Slows the Rate of Accelerated Brain Atrophy in Mild Cognitive Impairment: A Randomized Controlled Trial. PLoS ONE 5(9): e12244. doi:10.1371/journal.pone.0012244 http://www.plosone.org/article/info:doi/10.1371/journal.pone.0012244
  • 108. LifePak Nano - % RDA in 2 packets • B12 1,000% (as 60 MICROgrams cyanocobalamin) HOMOCYSTEINE • B6 500% lowering • Folic acid/folate - 150% • Magnesium 76% (as 300 Mg amino acid chelate) • Zinc 100% (15 mg as zinc chelate) • Selenium 200% (L-selenomethionine & NaSeO3) • Iodine 76% • Chromium 166% • Vitamin C 834% • Vitamin A 300% (83% as Beta carotene and plant extracts)
  • 109. OK. It slows shrinkage. But are they sharper? [deJager CA et al. Int J Geriatr Psychiatry. 2012 June;27(6):592-600] “B-vitamins appear to slow cognitive and clinical decline in people with MCI.”
  • 110. The Effects of high dose B vitamins on stress at work • 3 month, double blind, placebo control, randomized study – Measured: Personality, work demands, mood, anxiety, and strain • The vitamin B complex treated group reported significantly lower personal strain and a reduction in confusion and depressed/dejected mood after 12 weeks. Strough C et al. The effect of 90 day administration of a high dose vitamin Bcomplex on work stress. Hum Psychopharmacol. 2011 Sept 8. doi 10.1002/hup.1229 (Swinburne University of Technology – Hawthorn, Victoria, Australia.)
  • 111. “Micronutrient supplementation has a beneficial effect on perceived stress, mild psychiatric symptoms, and aspects of mood in apparently healthy individuals. Supplements containing high doses of B vitamins may be more effective in improving mood states.”
  • 112. What happens with biotin deficiency? Two LifePak Nano packets have 100% of recommended daily requirements of Biotin. “Our results suggest that biotin deficiency promotes hyperglycemic mechanisms…and decreased insulin secretion and sensitivity to compensate for reduced blood glucose concentrations.”
  • 113. OK. So I’ll just drink carrot juice and pop some high potency B’s. What me worry?
  • 114. Total organic fruits/vegetables intake, 9 – 12 servings per day. No supplements.
  • 115. 20 years ago - a hint of bad things to come… • North Americans, unfortunately, obtain about one-third of their total calories from nutrient-poor junk food. Even well-educated… adults…. fall short in their consumption of important minerals, like magnesium, iron, zinc, and calcium. Hallfrisch, J., Muller, D. 1993. Experimental Gerontology, v28 : 473-83.
  • 116. Magnesium mementos • One of the first minerals to disappear with: – Processed food – Stress • Decreased by EtOH, caffeine, sodas, meds • Considered “anti-stress” mineral – Decreases cortisol (rel to sleep disruption) – Relaxes muscles, prevents cramps – Decreases anxiety; improves sleep
  • 117. Symptoms of Magnesium Deficiency PSYCHIATRIC ISSUES: •Difficulty with memory and concentration •Depression, apathy •Emotional lability •Irritability, nervousness, anxiety •Insomnia Autism ADHD Health Conditions Associated with Magnesium Deficiency  Migraine headaches  PMS  Dysmenorrhea  Fibromyalgia  Fatigue  CONSTIPATION
  • 118. SELENIUM DEFICIENCY in FASEB: • “Adaptive dysfunction of selenoproteins from the perspective of the ‘triage’ theory: why modest selenium deficiency may increase risk of diseases of aging.” Foundation of American Societies for Experimental Biology McCann, J, Ames BM. FASEB J. 2011 Jun;25(6):1793-814.
  • 119. I+ Se+  “the foot soldier” LifePak Nano has 200% of RDA of selenium. And 76%of RDA of iodine.
  • 120. Low Zinc associated with low testosterone • Per USDA, 60% of US men between 20 – 49 years of age do not get enough. – [N.B.: Do not supplement with > 50 mg daily (can interfere with Cu+ metabolism); rationale for SYSTEMS approach] • Tsai, E.C., Boyko, E.J., Leonetti, D.L., & Fujimoto, W.Y. (2000). Low serum testosterone level as a predictor of increased visceral fat in JapaneseAmerican men. International Journal of Obesity and Related Metabolic Disorders, 24, 485-491 LifePak Nano has 100% of daily RDA for Zinc.
  • 121. Erectile dysfunction & antioxidants with MVI’s??
  • 122. Ways to improve erectile quality (LP Nano concentrations in parentheses) • Holistic: physical exercise, improved nutrition, weight control (R90 & TR90) • Supplements: adequate intake – Omega 3 fatty acids ( ~4 grams/ day in LP Nano) – Antioxidants {+++} – Calcium (600 mg = 60%) – Folic acid (folate – 600 ug = 150%) • RX: Replacement of any T deficiency Meldrum DR et al. The link between erectile and cardiovascular health: the canary in the coal mine. Am J Cardiol. 2011 Aug 15;108(4):599-606
  • 123. Addresses Nutrient Deficiencies Get ADEQUATE nutrients, not just the bare minimum from “RDA” Optimal nutrient level supported by safety and efficacy studies RDA level critical level deficiency syndrome Rx: Any “MVI” used should have its results MEASURED
  • 124. A SYSTEMS approach to nutritional optimization 3 ega- s Om cid tty a fa nts trie ns mi onu vita hyt P nts s a ral xid ine ntio m lth) A hea one (b
  • 125. What does “Nano” mean? • Cylcodextrin ring – benign, digestable • Feeds the gut microflora
  • 126. How do nano-nutrients work? Fat-soluble nutrients like Nano-encapsulated nutrients do carotenoids and coenzyme Q10 not clump; they DISPERSE. CLUMP in watery milieu.
  • 127. The Nanotechnology Difference pmol/mg protein 5-fold increase in absorption! Adapted from Craft et al, FASEB Journal. 2005; 19(4): Abstract #281.6, A449. γ-cyclodextrin complex
  • 128. Some personal reflections
  • 129. Accessed 2/6/2014
  • 130. Accessed 2/6/2014
  • 131. October 5th, 2013
  • 132. TUNA procedure And a little bit of discharge planning
  • 133. Accessed 2/6/2014
  • 134. Accessed 2/6/2014
  • 135. “About 80% of your genetic material is made up not of genes but of gene switches. These switches cause changes in the way a gene works; this is called Gene Expression” Dr. Oz comments about “gene expression” science Source: Dr. Oz Q&A 2012
  • 136. TARGET & RESET YOUTH GENE CLUSTERS Young Gene Expression TARGET Old Gene Expression Old Gene Expression RESET Transcriptional Biomarkers of Mitochondrial Aging and Modulation by Cordyceps Sinensis Cs-4. Gordon Research Conference, Biology of Aging, Determinants of Health-Span: From Cells to Humans, August 22-27, 2010. Les Diablerets Conference Center, Les Diablerets, Switzerland. 1
  • 137. “Youth Gene Clusters” – bogus or bonanza? Yeast species SPECIFIC genes Comparative genomics of fungal allergens and epitopes show widespread distribution of closely related allergen and epitope orthologues. Bower P, et al, BMC Genomics. 2006; 7:251.
  • 138. Prostate Cancer – more relevant? Pre-invention gene expression Post-intervention gene expression TRANSLATION: What you eat talks to your genes and CHANGES THEIR EXPRESSION. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Ornish, Dean Proc Natl Acad Sci USA 2008 June 17; 105(24):8369-8374 et al.
  • 139. An Entirely New Class of Anti-aging Products
  • 140. BEFORE AFTER 6 MONTHS *Twice daily usage of ageLOC Transformation, and twice weekly usage of ageLOC Galvanic Spa and Facial Gels.
  • 141. Mitochondrial Damage: Loss of Energy Mitochondria Free radical damage alters their energy production capability. Plus, they “breathe their own exhaust.”
  • 142. MITOCHONDRIAL ACTIVITY DECLINES WITH AGE 8 6 - 40% 4 2 18~39 61~84 ”Mitochondrial Dysfunction in the Elderly: Possible Role in Insulin Resistance” Science 16 May 2003:Vol. 300. no. 5622, pp. 1140 – 1142
  • 143. Three active botanicals: •Cordyceps •Pomegranate extract •Panax ginseng Promotes Three Dimensions of Vitality:* •Physical Vigor •Mental Acuity •Sexual Health * These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
  • 144. Active mitochondrial research on energy
  • 145. http://www.nature.com/scitable/topicpage/mtdna-andmitochondrial-diseases-903
  • 146. Week 12 = +20% P=0.021 Vitality vs. Placebo “Targeting Age-related gene expression improves mental and physical vitality” Ferguson SB SM et al. Paper presented at 1st World Congress on Targeting Mitochondria, Strategies, Innovations & Clinical Applications. Berlin, German. November 18-19, 2010.
  • 147. Fat Docs • Positive correlation between BMI and & mortality • 85,078 men ages 40 – 84 in Physician’s Health Study enrollment – “The relative risks of all cause mortality increased in a stepwise fashion with increasing BMI.” – Alani UA et al. Body mass index and mortality among US male physicians Ann. Epidemiol. 2004 Nov;14(10):731-9. (c) 2013 Louis B. Cady, M.D. - all rights reserved
  • 148. Identification of Gene Expression Pathways Linked to Fat Storage and Fat Metabolism LifeGen pre-clinical study of Adipose, Gastrocnemius muscle, Hypothalamus
  • 149. Gene Expression relates to the Appetite Control Center of the Brain • • • Appetite Control Eating Behavior Regulation of energy intake Ghrelin Leptin Insulin References: 1. 2. 3. 4. 5. 6. 7. 8. 9. Smeets et al. Proceeding of the Nutrition Society. 2012;71:511-520. Guthoff M, et al. J Clin Endocrinol Metab. 2010;95:748-755. De Silva, et al. Cell Metab. 2011;14:700-706. Malik S, et al. Cell Metab. 2008;7:400-409. Farooqi IS, et al. Science. 2007;317:1355 Suzuki K, et al. Experimental Diabetes Research. 2012:1-19. Viquerie N, et al. Diabetologia. 2005;48(1):123-131. Mager et al. European Journal of Endocrinology. 2008;158: Mutch DM, et al. Am J Clin Nutr. 2011;94(6):1399-1409.
  • 150. Withings WS-50 Smart Body Analyzer
  • 151. (Start weight: 168.5 lbs – Oct 28th) 10 lbs of total weight loss = 6% body weight
  • 152. (43.1 lbs – Oct 28th) 7.7lbs of fat loss 10 lbs of total loss = 77% of weight loss was FAT loss
  • 153. TR 90 – a look back October 28, 2013 January 28, 2014
  • 154. Stats & Significance • Confounds: – Time of year – Halloween & Holidays – Busy schedule. Travel. Meals on road. – Somewhat imperfect execution • Results: – 10 lbs gone (of which 7.7 lbs was fat) – Lost: • 2.5 on waist • 4% body fat (from 26.5% down to 22.5%)
  • 155. Final reflections….
  • 156. “work ‘til you drop or can retire” plan The “Cash Flow Quadrant” concept by Kyosaki The Facts of Life of Business • You have a job. (E) • You own a job (or it owns you). (S) • You have built a business (& your minions make money for you) (B) • You have so much money you can live off your investments (I).
  • 157. Business 101 – 3 doctor internal medicine clinic – what does this REALLY MEAN? As your fees stagnate or are cut, and as yourEXPENSES: overhead INCOME continues to rise, you will: (prev) Revenue: $1.5 million Overhead* : million •Pinch pennies on overhead, do 5-7 minutes per$1depreciation, patient [support staff salaries, rent, Less 24% cut: - $360,000 malpractice and try to be cheap. (Unsuccessful). insurance, license fees, “MOC” fees, equipment costs, consumables, cleaning, •Work harder and longer hours to keepfacilities insurance, Workman’s supplies, pace and feed Total income now:$1,140,000 officecomp, retirement plans for staff and docs, your family (and burn yourself out)… pay, sick pay, insurance plans CME, vacation Income lessnot get to see your kids grow up. for staff and docs] • …And expenses (What’s left over for = ZERO. • Marital problems; divorce. salaries: $140,000) • This balances. out on life. You will miss Salaries – for 3 docs •Use the “work ‘til you drop” retirement plan. Total expenses: $1.14 •Or= 46,667 per doc you will quit if you’ve made enough and eithermillion retire or do something else.
  • 158. The Third Way: the health matrix dialectic Or… Doctors, dentists, optometrists, DC’s, ND’s, NP’s & other health care & fitness professionals: You can synergize with your patients’ needs and contribute to the health of America
  • 159. May 1, 2013
  • 160. A personal close: How do YOU want to age? Me – Jan 2013
  • 161. October 5th, 2013
  • 162. Wrapping Up: The “Survival Curve” – Where Are You?
  • 163. What can you do at 100? • Rita Levi Montalcini, MD • Nobel Prize – Medicine 1986 • Birthday – April 18, 1909 • “At 100, I have a mind that is superior – thanks to experience – than when I was 20.”
  • 164. Dr. Catherine Hamlin, MD. 90 years of age. Still practicing ob-gyn in Ethiopia. Focus: repairing obstetric fistulae. Source: http://www.nytimes.com/2014/02/06/opinion/kristof-at-90-this-doctor-is-still-calling.html?_r=0 accessed 02 08 2014. photo by Joni Kabana
  • 165. “There are things known and there are things unknown, and in between are the doors.” - Jim Morrison
  • 166. “Truth is a constant variable.” – William Mayo, MD. “Dr. Will” Gonda extension, Mayo Clinic Building 2004. © Louis B. Cady, M.D.
  • 167. “Probably the most interesting period of medicine has been that of the last few decades. So rapid has been this advance, as new knowledge developed, that the truth of each year was necessarily modified by new evidence, making the truth an ever-changing factor.” - Charles Mayo, MD “Dr. Charlie” Plummer Building lobby. Photo: © Louis B. Cady, MD 2004