Robb Wolf, B.S. presenting at the Ancestral Health Symposium 2012 (AHS12) City Zero: How Markets and Evolution Can Revolutionize Medicine Abstract: 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. Bio: 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.

2. Part 1:
Economics & Moore’s Law

9. Diabetes: 2050

10. Where markets and technology
meet

11. 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?

12. 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

13.  Founded in 1993
 Initially Orthopedic risk assessment
 Could Metabolic risk assessment save lives (and money)?

14. 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!

15. Paradigm Shift
 Low Carb
 National Lipid Association
 NMR testing via Liposcience Labs

16. Current program
 Yearly risk screening
 High-risk individuals receive:
 Low Carb/Paleo*
 Targeted pharmaceuticals (statins**, metformin***)
 Sleep counseling
 Exercise: metabolic conditioning

30. Pilot Study
 Number of participants 33
 Program costs-$1000
 Program savings
 20/1 ROI $22million saved (prorated over 20 year period)

31. 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?

32. LDL is part of the Innate Immune
Response!

34. Metformin improves insulin sensitivity AND
prevents LPS toxicity

35. “The protective effects of the metformin treatment on the
onset of fructose-induced non-alcoholic fatty liver disease
(NAFLD) were associated with a protection against the
loss of the tight junction proteins occludin and zonula
occludens 1 in the duodenum of fructose-fed mice and the
increased translocation of bacterial endotoxin found in
mice only fed with fructose.”

36. “…Taken together, these data suggest that
metformin not only protects the liver from the
onset of fructose-induced NAFLD through
mechanisms involving its direct effects on
hepatic insulin signaling but rather through
altering intestinal permeability and
subsequently the endotoxin-dependent
activation of hepatic Kupffer cells.”

37. Statins: Cholesterol Reduction or
anti-inflammatory?

38. Addition of the Paleo Template
 Intestinal permeability and autoimmunity
 Integrating screening for:
 Intestinal permeability
 Autoimmunity

39. 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

40. Epilogue: It’s all connected.
And stuff.

42. Dedicated to the Next Generation