Jeffrey S. Bland, PhD, FACN, CNS, author of the book, The Disease Delusion, raises the question: “If you had to choose between disease care and health care, which would you choose?” Those Americans who are fortunate enough to have health insurance might agree that we have high quality or better than adequate health care in the U.S. Yet, despite the development of new drugs and procedures, the rates of highly preventable chronic diseases have continued to escalate to the degree that approximately 40% of all American adults and 8% of our children have at least one chronic condition and nearly 1 in 3 have multiple chronic conditions. According to the Centers for Disease Control and Prevention (CDC), chronic diseases are responsible for 7 of 10 deaths every year and account for 86% of our nation’s health care costs.
Conventional medicine is designed to treat acute disease, trauma, infections and emergencies and, in those instances, works exceedingly well. However, for treatment of chronic disease, defined as any disease lasting more than 3 months, conventional medicine tends to target and treat the symptoms, as opposed to finding any fundamental causes of disease. Since the invention of antibiotics, conventional medicine has depended upon finding “a pill for every ill,” resulting in 4 billion pharmaceutical prescriptions filled annually, many of which have multiple side effects. The standard model of conventional medical care is diagnosis of disease and matching that disease with a corresponding drug to mask or treat the symptoms of the disease. Sadly, we are failing miserably at getting to the root causes in the treatment of chronic diseases. Unfortunately, most doctors are not adequately trained to properly apply strategies such as nutrition, diet or exercise to either prevent or treat chronic illnesses, as medical students routinely receive less than 20 hours of training in nutritional and lifestyle instruction.
Clearly, something needs to change, as Americans’ life spans are shortening and we are growing sicker than ever. It appears that we are at a disadvantage and are losing a winnable battle of good health versus chronic illness. What’s causing not only Americans, but also citizens around the developed world, to increasingly suffer from life threatening chronic diseases and conditions that include hypertension, type 2 diabetes, arthritis, metabolic syndrome, obesity, depression, autoimmune diseases, cancer and our number one killer, cardiovascular disease? It appears that a person’s individual genetic make-up along with lifestyle choices are at the root of chronic illness and are key contributors in the development and progression of many preventable chronic medical conditions.
Functional medicine essentially shifts health care from a disease focus to a health focus. Dr. Bland, considered the father of functional medicine, states, “The future of health care and medicine lies in recognizing that lifestyle, diet and environmental factors influence how our genes are expressed into our health and disease patterns” and “that science-based solutions can help alleviate these ever more common conditions, leading to a lifetime of wellness.” In other words, functional medicine looks at the interactions of genetic, environmental and lifestyle factors that influence long term health. Those who suffer from allergic, digestive, hormonal, metabolic and neurological problems may find answers in the field of functional medicine.
What are some of the causes of chronic illness? Generally, disease is caused by an underlying dysfunction, such as digestive, absorption or mitochondrial dysfunction or an imbalance of bodily systems, including immune, hormonal, structural, inflammatory and detoxification systems. Treating just the symptoms may bring some temporary or minimal relief, but rarely leads to long-term heath or vibrancy. Functional medicine differs from conventional medicine in that it endeavors to understand the sometimes multiple origins of very complex chronic diseases, and takes an integrative, patient-centered, science-based approach in prevention and treatment with a goal of achieving wellness. Good health, it seems, is not only the absence of disease, but a state of immense vitality.
While our system of acute care and emergency treatment is effective and efficient, clearly, the dominant medical challenge facing us now is helping those with chronic illnesses regain their health. Unlike acute conditions, chronic disease is not self-limiting and will worsen over time. To win the battle, we need to change the messages that our diets, lifestyles and environments are sending to our genes and reverse the dysfunctions that are making us sick. The functional medicine approach seeks to find and address physiological network imbalances to deal with chronic ill health. What does this mean and how does functional medicine find and address imbalances? Although everyone has a unique genetic predisposition, we all have the same core physiological processes that can be addressed.
- Assimilation and elimination – Digestion, absorption, utilization and elimination of nutrients is a multistage process. Imbalances at any stage of the process can lead to disorders.
- Detoxification – These processes occur primarily in the liver, where toxic substances are converted into nontoxic by-products and eliminated. Genetics play a huge role in controlling the body’s detoxification processes. Any deficiency in detoxification ability typically results in chronic illness.
- Defense – Our immune system is our great cellular defender that must not only protect us from infection and injury but must also eliminate old and dead cells and other debris that can accumulate in the body. Your immune system has a major and direct influence on your overall health and life span. Failure is not an option.
- Cellular communication – Our cells continually communicate and influence our physiological processes both inside and outside the cells. Any altered cellular function can result in symptoms associated with many chronic illnesses.
- Cellular transport – Our circulatory systems transport substances from one part of the body to another. Our blood is constantly refreshed, while nutrients are carried to cells and byproducts are carried away. Altered function of our transport system can result in a range of disorders, including cardiovascular disease, the most destructive chronic illness.
- Energy – Processes that convert food into energy and manage its use occur in the mitochondria of the cells. Alteration of mitochondrial function typically results in chronic health issues associated with fatigue and pain.
- Structure – Bodily structure that includes our bones and connective tissues support health and proper bodily function. Any changes in the structure results in changes in function, increasing the risk of chronic illness.
The goal of functional medicine is to identify, assess and address core clinical imbalances to improve wellness and achieve optimal long term health. The tools of functional medicine are comprised of diet, including medical foods, supplemental nutrition, such as nutraceuticals and phytochemicals, exercise, lifestyle and behavior therapies and environmental modifications. The more we realize that we are in control of our own wellbeing and that our lifestyle choices intersect with our genes to either support good health or contribute to chronic illness, the more likely we are to make the sustained lifestyle changes necessary to improve health. In summation, functional medicine aims to target your unique genetic potential to restore healthy balance to your own core physiological processes to enhance wellness and lead to a longer, much healthier life span.
About Chronic Diseases.
Bland, Dr. Jeffrey S. The Disease Delusion. HarperCollins Publishers, 2014
The Good And Bad Of Alternative Versus Conventional Medicine.
What is Functional Medicine?
Lifestyle Choices: Root Causes of Chronic Diseases.
Chronic Diseases: The Leading Causes of Death and Disability in the United States.