Functional Medicine & Staying Healthy With a Long Health-Span
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Key Points > What is Functional Medicine and the Cellular Terrain? Functional Medicine is all about preventing or reversing disease processes. The Cellular Terrain is everything in Functional Medicine and this is explained below in more detail. The hallmark of Functional Medicine is to find nutritional insufficiencies or deficiencies and other factors such as toxic esposures (toxic exposome), genetic predispositions or gut microbiome abnormalities that can result in early disease and to then intervene as soon as possible in this process to prevent progression. > How does Precision Nutrition work for Functional Medicine Approaches? Precision Nutrition as the name suggests is all about finding weaknesses in an individual so that a targeted approach in nutrition and lifestyle management can be used. All of this is put into the clinical context of the individual. The pillars of Precision Nutrition are:
> What distinguishes Functional Medicine from Interventionist Medicine (the usual form)? I have created two graphic representations below that will provide a visual of the important points of distinction between these two vastly different approaches to practicing medicine. This is not to say they are mutually exclusive but doctors like me see great neglect in the use of symptomatic and interventionist medical approaches by doctors that ignore the critical need for cells to be nourished for healing and repair mechanisms to even begin to function.This approach is like putting on a superficial skin coloured dressing over a festering wound that gives the appearance of normality. This interventionist, pharmacological approach is ignorant of the fact that the body and brain are complex biological systems requiring critical dietary inputs to function. Medicine can be so much more than this one-sided interventionist approach. Functional Medicine doctors want to ensure healing occurs at the cellular level by providing the cells with all the nutritional support they need and to target imbalances or insufficiencies or deficiencies and to dampen inflammatory processes that impair healing. > What is the concept of 'Cellular Terrain'? The cellular terrain simply means the connective tissue surrounding cells, the interstitial fluid that bathes those cells, the circulatory systems such as the blood or lymphatics that supply and get rid of metabolic waste products, the tissues that make up organ and musculoskeletal systems and then the interrelated organ systems that makeup a human body. By taking care to optimise the Cellular Terrain, you are keeping your body healthy at the level of your cells upwards. By concentrating on the Cellular Terrain (CT) through diet, exercise, the 'Exposome' i.e. all the non-genetic exposures toxic or otherwise, you will be ensuring healthy cells, tissues and organ systems that make up a unified and functional system that is the human body. With a healthy cellular terrain in place, you can ensure optimal repair and restorative mechanisms that stimulates cellular health and repair mechanisms. The aim is to prevent disease for as long as possible and ensure a long health-span. Any disease needs to be managed at this cellular terrain level rather than just dealing with the effects of damaged cells and organ systems through symptomatic management only as interventionist medicine does. Without treating the Cellular Terrain, you are just applying a 'band-aid' interventionist approach to the management of disease states and a less than optimal Cellular Terrain will mean that you will age faster and have a shorter health-span. It is beyond belief that this form of medicine is not the norm. To think that the body is anything other than an amalgam of biological compounds requring a multitude of nutrients to function is naive in the extreme. The body does not (and will never), suffer a "pharmaceutical deficiency" it craves nutrients to function and to support repair mechanisms to keep the body functioning in an optimal state.
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Modern Medical Interventionist Approach
Modern medicine waits for a disease to manifest and only then does it take action.
The treatment is directed at downstream effects and towards symptomatic relief but it is unheard of that there is focused treatment directed towards providing cells, tissues and organ systems with the nutritional resources needed to correct nutritional-related factors that drive oxidative stress and inflammation or dysfunctional metabolism due to micronutrient deficiencies or uncontrolled inflammation driven by Omega-6 to Omega-3 imbalances. Rarely if ever is the gut microbiome assessed or a detailed dietary analysis done or tests done to see what may be driving inflammation including Insulin Resistance (IR) that is extremely common and a factor driving many chronic diseases. Insulin Resistance is a prediabetic state with mounting evidence that associated Insulin Resistance of the brain is driving many neurodegenerative diseases and has a powerful impact on mental health. Please view the mental health blog. CLICK HERE
Modern medicine is a band-aid approach but this is not to say such approaches do not have a role to play but not at the expense of setting up a solid nutritional and lifestyle foundation for such therapies.
The following graphic sums up the modern medical approach.
The Functional Medical Approach
The aim with Functional Medicine is for you to 'Live Long and Die Young' - in other words to have a very long health-span rather than living a long life riddled with disease where you have multiple medications and where your exercise tolerance is so poor that you cannot enjoy things in life like travel, exercise or hobbies.
Interventionist medicine keeps you alive in a damaged and poorly functional state whereas funtional medicine keeps you healthy for as long as possible with minimal treatments (if any), enabling you to enjoy a long and active life.
The functional medical approach is vastly different. Functional Medicine targets cells and the Cellular Terrain and provides them with all the micronutrients necessary for cells to function optimally and for cell repair including essential fatty acids and a vast array of vitamins, minerals, trace elements and includes 1000's of plant-based phytochemicals, and a diversity of dietary fibre. Functional Medicine's toolkit looks at a personalised diet, the gut microbiome, your personal genetic profile (Nutrigenomics) along with the exposome and personalised exercise to fine-tune the highly integrated system of the body from the cells up.
Human cells and their cellular terrain are under constant attack from environmental factors or internal metabolic effects such as oxidative stress, and so a 'well-oiled' 'well-tuned' system of cells in a well-nourished and well-prepared cellular terrain enables the body to withstand such assaults on both the cells and their cellular terrain effectively. Without a well-prepared system to withstand a multitude of dangerous internal and external assaults, disease will begin to manifest.
Functional Medicine's aim is to prevent disease through early intervention by modifying upstream effects and dysfunction by using Precision Nutrition approaches which adopt advanced cutting-edge tools in medicine such as:
- In-Depth Dietary Analysis (diet diary through an App and advanced software analysis)
- Genomics (Genetics) in particular Nutrigenomics
- Gut Microbiome Assessments
- General and Functional Laboratory Testing
These tools in medicine can detect early abnormalities that can then be targeted through diet and lifestyle approaches.
Avoiding the Triage Mechanism of Auto-Cannibalism and impaired DNA repair processes
In a nutrient-depleted state the body will 'Rob Peter to Pay Paul' - nutrients will be shunted from muscle or bone and even non-vital organs like the liver which are not needed for immediate survival but can slowy deteriorate over time in a functional although diminished state unlike an impaired heart which can lead to immediate death. So organs like the heart, brain and kidneys are given priority for nutrient supply.
The Triage Mechanism was proposed by Professor Bruce Ames a Molecular and Biochemistry expert who developed this theory from observations of DNA damage caused by micronutrient deficiencies. Research has backed this theory and it makes absolute sense that in a micronutrient insufficient state that nutrients will be shunted from non-vital organs to vital organs.
Exercise is a stressor to the human body, increasing metabolic activity and oxygen consumption as the body needs vast amounts of energy to be able to cope with moderate or strenuous exercise as you are engaging large muscle groups, the heart and vascular system and greatly increasing mitochondrial activity that will provide the energy (ATP) needed for all the muscle metabolic activity and then protein synthesis to increase lean muscle mass. 
Exercised muscle will need far more nutrient resources both immediately in the peri-exercise period and an ongoing supply of nutrient resources for post-exercise repair and protein synthesis. Without adequate nutrient support for exercise, in particular Essential Amino Acids (EAAs) the Triage Mechanism will kick-in to weaken and not strengthen the body. Exercise in a nutrient depleted state now becomes a liability rather than something that supports health.
Thus in a state of micronutrient or amino acid deficiency, the body will shunt t
hese scarce micronutrients to vital organs like the heart, brain and kidneys as you can live a very long time if your muscles or bones or non-vital organ systems such as the liver were raided to supply the vital organs but you will survive in a diseased state where you will suffer from osteopenia or osteoporosis, decreased organ function, decreased organ size and sarcopenia (muscle loss) over time.
Thus exercising without a fully nourised and nurtured cellular terrain and exercising without providing the building blocks for effective protein synthesis and increased muscle mass to me is an absolutely futile waste of effort! Muscle does not grow on the air in the gym it needs all the micronutrients necessary for optimised metabolic systems.
L-Leucine is an absolutely critical essential amino acid for protein synthesis through the mTOR pathway. L-Leucine, Isoleucine and Valine are the three BCAAs and these are all a part of the Essential Amino Acid (EAA) blend provide by Activ8Health.
There are many supportive micronutrients for exercise that optimise the cellular terrain and these need to be provided if exercise is to be meaningful.
Physiotherapy & The Cellular Terrain: Micronutrient Resources for Tissue Repair
As a medical practitioner who is writing this blog with a great deal of experience of dealing with patients at the primary care level, it stuns me as to the ignorance of medical practice where symptoms are treated only and where the body is not treated as an integrated biological system that requires food, nutrients and energy to heal itself. 
This ignorance was revealed at Westmead Hospital in Sydney where Scurvy was found in 21st Century Sydney. Non-healing diabetic ulcers have always been a problem and managed by slapping on a variety of potions, pastes and lotions to the ulcer willing it to heal by the topical application of something thick and sticky. Westmead Hospital's specialists decided to test for Vitamin-C levels and lo and behold, these people were suffering from significant Vitamin-C deficiencies (Scurvy). When Vitamin-C was given, healing occurred wthout amputation in all those treated with Vitamin-C in contrast to 44% in the control group.
Many nutritional 'experts' advise people to simply eat an optimal diet! This is seemingly wonderful advice but is obviously not working when 60% of many Western populations are suffering from overweight, obesity and a myriad number of chronic illnesses that have a dietary basis.
Survey after survey show severely inadequate intakes of fruit and vegetables to the extent that around 95% of the population are not getting anywhere near their recommended intakes of fresh food. Most of our minerals and trace elements will come from fruit and vegetables and to add more misery to this story is the fact that the Western diet is riddled with inadequacies. So I am not sure where this fabled 'optimal diet' exists?
In this context, the cellular terrain will be greatly impaired for most people and ensuring micronutrient sufficiency will undoubtedly help injuries that do not seem to be improving.
This is what Functional Physiotherapy is all about not just using physical and topical modalities of treatment but to treat from the cellular terrain up.
Specialised formulations do exist but require practitioner input. Please contact an Activ8Health practitioner to provide you with more information.
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