Top Trends from the Integrative Healthcare Symposium
Last month, industry leaders gathered at the 2023 Integrative Healthcare Symposium in New York City to discuss the most recent research, technology, and treatment protocols in integrative medicine.
As to be expected, gut health and inflammation were throughlines across presentations. However, more niche topics such as trauma, personalized nutrition, longevity, and environmental toxicity also emerged as some of the event’s most prominent themes.
Here we identify the top trends from the symposium that set the stage for the rest of 2023.
Evaluating and Treating Patients for Arsenic Toxicity
“How many of you are aware that the primary cause of death is arsenic,” Joseph Pizzorno, ND, asked during a panel on Environmental Medicine.
According to Pizzorno’s research, arsenic plays a significant role in many life-threatening diseases. Eighteen percent of diabetes cases in the United States, he said, are due to arsenic, along with one third of prostate cancer cases, 14 percent of bladder cancer, and 50 percent of gout.
Environmental medicine emerged as a major topic at this year’s symposium, with arsenic toxicity taking center stage. Arsenic, a toxic substance found most commonly in groundwater, was ranked as the United States’ number one priority on the 2016 Agency for Toxic Substances and Disease Registry.
According to Pizzorno’s research, not only is arsenic highly toxic and associated with a plethora of diseases, but the potential for human exposure is significant—with 35 percent of the U.S. population having blood levels of the toxin that put them at risk. Minority populations have a particularly high risk of arsenic exposure, he explained. In Genesee County, for instance, the home of Flint, Michigan, a city with a history of toxic water supplies and a population that’s majority Black, 43 percent of the water supply had more than 10 micrograms of arsenic pollution.
“The need for our medicine in these areas is huge,” Pizzorno said.
A main takeaway from the panel, arsenic testing is crucial, and should become routine in general care. According to Lyn Patrick, ND, who presented alongside Pizzorno, for the most accurate results, arsenic should be tested in the urine, not the blood.
“Arsenic is not useful as a blood level; only for acute toxicity will it go up,” said Lyn. “Urine is the gold standard for measuring arsenic.
Using Lifestyle Changes to Stay Forever Biologically Young
Aging is not a disease. said Mark Hyman, MD, at his keynote address. “What’s happening in the world today is our health span has been contracted and the last 20 percent of our lives we’re in poor health.”
That does not need to be the case. Chronological and biological aging, and the difference between them, was underlined at this year’s conference. Unfortunately, we associate aging will disease and illness, but Hyman and other practitioners agreed that improved lifestyle factors could significantly change dysfunctions in the hallmarks of aging and how well we live in our twilight years.
In their presentation, Monique Class, MS, APRN, BC, IFMCP, and Kelea Wattles ND, IFMP said aging is a measure of biology, not a measure of time. They discussed subfertility as a marker for accelerated biological, not chronological, aging and chronic illness. In that sense, women can view subfertility as an early biomarker—an opportunity to make long-term lifestyle changes leading to both positive fertility and improved later-life outcomes.
Through epigenetic testing, we can now measure our biological age, explained Hyman, who said at 62 years old, his biological age is 40. In addition to traditional biomarkers like glucose, CRP, and hormones, we now can test for hundreds of biomarkers, including novel ones like methylation, genetic age, telomeres, and mitosis, he said. We now have a chance to change our epigenome in real time.
Regardless of our health goals, Hyman, Class, Wattles as well as other practitioners in attendance, agreed on topline lifestyle hacks for longevity: from mindfulness to meditation to protein and phytochemical intake, resistance training, and community. Said Hyman, “The body is not necessarily designed to completely come apart as we get older. We can maintain a really high level of functioning and have our health span equal our lifespan.”
Tackling Trauma, Anxiety, and Depression with Individualized and Foundational Approaches
“I look at trauma with hopefulness—that a profound change can happen after trauma,“ said James Gordon, MD, who discussed methods to deal with planetary, group, and personal trauma in his symposium presentation. “When all of our notions of who we are and what we are meant to do come into question, that disintegration becomes the path to reintegration.”
Trauma, depression, anxiety, and mind-body medicine and how to approach them from very personalized to wide-reaching ways were top topics at this year’s symposium.
Gordon pointed out how trauma can be personal and all-encompassing but also a shared experience globally, both directly and indirectly. “We are all connected not only through the air we breathe but also through our universal experience of trauma.”
This is why Gordon and his Center for Mind-Body Medicine in Washington, DC, work with individuals and groups but also whole communities, hospitals, medical schools, and countries to teach foundational skills to combat trauma, like soft belly breathing and expressive meditation.
David Brady, ND discussed trauma, depression, and anxiety as it connects to the gut microbiome citing research that found a distinction between the microbiota in patients who were depressed versus those who were not. “They identified 13 different microbial taxa that were significantly and consistently different between depressed and non-depressed people, Brady said. “The takeaway is that microbiota in patients with depression is not the same as in patients without depression. There is an imbalance in the gut and it’s not in a favorable way.”
Brady discussed novel testing and tools available to practitioners in the areas of microbiomics, genomics, and metabolomics which present multiple ways to personalize treatment. He also shared foundational protocols to push the microbiota to a healthy state such as pre-and probiotics, oil of oregano and other botanicals, resistant starch, and exercise.
Helping Patients Achieve Nutritional Goals with Personalized Programs
“A lot of the stuff that your patients actually need is not what you should be doing,” said Ashley Koff, RD during her presentation on personalized medicine. “It's not what you’re trained to be doing.”
According to Koff, founder of The Better Nutrition Program, integrative practitioners alone can’t help patients achieve their nutrition goals, nor should they. Successful nutrition programs have to address a patient’s needs from all angles, Koff said. That includes consistent support, real-time evaluation, experimentation, and education. Yet, practitioners only have the skills, and bandwidth to provide clinical care which involves diagnosis, interpretation of data, and answering patient questions. Practitioners, Koff explained, should be homing in on what she called “their zone of genius,” and to do this, additional support and resources are necessary.
One form of this kind of support is wearable devices, according to Gregory Elliot, MS, CEP, DO(MP). In his presentation, Elliot explained that fitness trackers, continuous glucose monitors, and other devices monitor a patient's dietary and lifestyle habits, helping practitioners pinpoint problem areas, and better facilitate behavioral changes essential for disease management.
Koff also stressed the value of wearable data in addition to personalized nutrition programs that can educate patients on how to interpret that data as well as provide ways to improve their results with ongoing support from health coaches.
As speakers at the symposium reiterated over and over, diets are not one-size-fits-all. The success of a nutrition plan can be dependent on patient's medical history, gut health, food triggers, and even blood type. Moreover, depending on the product, certain legumes, nuts, fruits, and vegetables may have to be soaked, fermented, or cooked to avoid anti-nutrients and properly digest vitamins and minerals, according to Deanna Minich, PhD’s session.
For truly personalized care, Koff said, patients need to be equipped with recipes, lessons on how to read food labels, and places to shop, which require in-house programs in addition to regular healthcare visits.