AHS12 Robb Wolf, BS — City Zero: How Markets and Evolution Can Revolutionize Medicine


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Robb Wolf, B.S. presenting at the Ancestral Health Symposium 2012 (AHS12)

City Zero: How Markets and Evolution Can Revolutionize Medicine

An investigation of how markets influence medical innovation and a case history of how the Ancestral Health model has been implemented at the city level.

Robb Wolf, a former research biochemist, is the New York Times Best Selling author of The Paleo Solution: The Original Human Diet.

Robb has functioned as a review editor for the Journal of Nutrition and Metabolism, is co-founder of the nutrition and athletic training journal, The Performance Menu, and co-owner of NorCal Strength & Conditioning, one of the Men's Health Top 30 Gyms in America.

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  • CSU Grad in 1998-vegetarianBecame sick, found the paleo concept. Fixed my problemsResearch biochemist-Lipid metabolism, research fellowship with Loren CordainOpened gym, spoke internationally, wrote book, all on Paleo Nutrition & Lifestyle
  • We know more about biology, genetics pathology than EVER…but yet
  • Primary driver in healthcare related costs is obesity & related complications
  • Managed Care magazine.comUpper bound predicts 1 in 3 Americans with diabetes
  • Current prices range $600-1,000 before inflation!What if we had thee right theory operating with our best technology?
  • Risk manager from UNLV-3 significant CV eventsOff books costs 10X
  • Comprehensive survey of UNR police dept, looking for at risk cops
  • Results from screening were confusing as folks who looked fit were diabetic, insulin resistant etc. Todrenwick original guy looked healthy and fit
  • Nutritional approach was obvious problem. Low carb (ala Gary Taubes) were implemented
  • NMR normal
  • Discordance 134 YO male, LDL would not flag normal testing, although clear Insulin resistance via trig/HDL ratioTrig 362
  • LDL-P is 2,231, desirable is less than 1,000Triglycerides 362
  • Poor with hepatic LDL receptorsTend to become oxidizedBUT! High affinity for LPS!
  • Dead Man Walking
  • CD14 is a surface antigen of monocytes and immune cells. Processed by Kupfer cells, release of TNF
  • Ed Greenwald, circa 1930Robert Braidwood
  • Dear friend of the Greenwald familyPioneer in the archeological study of the transition from HG to agricultureCreated lifelong fascination in evolution and science for Dr. Greenwald
  • AHS12 Robb Wolf, BS — City Zero: How Markets and Evolution Can Revolutionize Medicine

    1. 1. Part 1:Economics & Moore’s Law
    2. 2. Diabetes: 2050
    3. 3. Where markets and technology meet
    4. 4. Quick Recap: When technology advances goods & services improve, costs decrease. We know more about biology, genetics and pathology than ever. But…  Medical costs increase  Quality of care decreases  Disease rates increase HOW can this possibly be So? What are we doing wrong?
    5. 5. On the Job Selection Pressure: Cops were dying UNLV police officers  3 Cardiac events in 1 year Costs to retire an officer-$1.2  Real costs 1ox this amount
    6. 6.  Founded in 1993 Initially Orthopedic risk assessment Could Metabolic risk assessment save lives (and money)?
    7. 7. In the Beginning Standard blood work  HDL, LDL, total chol, Trig’s Framingham scores American Heart Association diet Results were dismal, often times worse than no intervention!
    8. 8. Paradigm Shift Low Carb National Lipid Association NMR testing via Liposcience Labs
    9. 9. Current program Yearly risk screening High-risk individuals receive:  Low Carb/Paleo*  Targeted pharmaceuticals (statins**, metformin***)  Sleep counseling  Exercise: metabolic conditioning
    10. 10. Pilot Study Number of participants 33 Program costs-$1000 Program savings  20/1 ROI $22million saved (prorated over 20 year period)
    11. 11. That’s great, But… Are we STILL treating symptoms? Is elevated LDL-P a symptom of intestinal permeability and systemic inflammation? What is the mechanism of action for statins and metformin?
    12. 12. LDL is part of the Innate Immune Response!
    13. 13. Metformin improves insulin sensitivity AND prevents LPS toxicity
    14. 14. “The protective effects of the metformin treatment on theonset of fructose-induced non-alcoholic fatty liver disease(NAFLD) were associated with a protection against theloss of the tight junction proteins occludin and zonulaoccludens 1 in the duodenum of fructose-fed mice and theincreased translocation of bacterial endotoxin found inmice only fed with fructose.”
    15. 15. “…Taken together, these data suggest thatmetformin not only protects the liver from theonset of fructose-induced NAFLD throughmechanisms involving its direct effects onhepatic insulin signaling but rather throughaltering intestinal permeability andsubsequently the endotoxin-dependentactivation of hepatic Kupffer cells.”
    16. 16. Statins: Cholesterol Reduction or anti-inflammatory?
    17. 17. Addition of the Paleo Template Intestinal permeability and autoimmunity Integrating screening for:  Intestinal permeability  Autoimmunity
    18. 18. What’s next Program encompassing all Reno Police & Fire  With inclusion of paleo/AH models of inflammation Spread program to global audience  45 Municipalities: Europe, AU, NZ, US Consolidate data collection via Specialty Health Release Health care provider education  Gyms, allied HC, MD’s Develop health insurance company pushing HSA’s and referral network to gyms, physicians & allied HCP’s
    19. 19. Epilogue: It’s all connected. And stuff.
    20. 20. Dedicated to the Next Generation