How technology, genomics, biometrics, support integrative and functional medicine
Health is personal, said Jeffrey Bland, PhD, FACN, FACB, CNS, president of the Personalized Lifestyle Medicine Institute, at the 2019 Integrative Healthcare Symposium in New York City.
“Lasting health comes from the interaction of our genes with our lifestyle and environment,” said Bland. “Personalizing this connection is the future.”
The digital revolution is changing the way we live. We’re becoming wired as a global community, said Bland.
Healthcare has evolved from what experts call “imprecision medicine,” where conditions are treated with generalized pharmaceuticals and patient protocols. Today, practitioners are starting to understand that care must be tailored to the individual, and technology plays a huge role in that.
The value proposition for technology in healthcare is often whether they artifacts of a replaceable society or are these devices and techniques and tools that are a part of this transition from where we have been to where we’re going, said Bland. He thinks it’s the latter.
“We’re evolving to a new planetary culture,” said Bland. “It is my belief that the singular most significant global transformation is the transition from being part of the group, to being an individual in the group.”
The role of the practitioner, therefore, is also evolving, with a new focus to empower and accelerate the power of the individual to do the best they can, said Bland.
The digital tools we now have access to are opening opportunities to evaluate and assess the body’s functions in ways we never had access to before. Wearable devices, for example, track way more than steps and calories. some have capabilities to measure EKG patterns, and are evolving to measuring continuous blood sugar measurements, blood pressure, and body composition, Bland said.
We can track how our body changes over the course of our daily routine, and how different activities—eating, interacting with others, exercising, or being in different environments—influence our physiological function, said Bland.
“We’re making our way to what’s called the quantified human revolution,” Bland said. “We’re starting to see ourselves as uniquely different in the way we respond to the events that we experience in our lives.”
Coupled with ever-evolving technology in genetics, genomics, and biomarkers, we are not only able to care for patients in the present but understand who they might become through our genetic potential, said Bland. The view that genes are not our destiny is still new, Bland said, and offer opportunities to really change how we are going to live, and to personalize our diet, our lifestyle, and our environmental exposures.
All these technological changes are creating a new way of thinking and development in integrative and functional medicine, Bland said. The wellness and health industry take us way from being a disease-centric country, he said, to being a country that is equally interested in keeping patients healthy as they are in treating disease.
Functional medicine is not about the diagnostic concept as much as it is about looking at antecedents, triggers, mediators, signs, and symptoms. That is the basis of the functional medicine model, he said. Health must be determined by measuring functional status, including physical, physiological, cognitive, and psychological function.
“Prevention is a non-quantifiable term,” said Bland. “You don’t know if you’ve prevented something unless you get it. We have a disease-care system to manage disease. We need a healthcare system to measure our health. No more of this prevention nonsense.”
The functional medicine model, Bland said, must be etiology-focused; the abnormal must be compared to the individual itself; and must be centered on networks; interconnected organ systems; and determination of underlying dysfunctions leading to symptoms.
Part of this new continuum that we’re being exposed to is program adherence, Bland said. This takes us back to technology—tools practitioners can use not only to understand a patient’s health but help them manage and monitor it. They can be behavior modification tools to reinforce what patients need to do to stay healthy.
What might this new functional medicine model look like? Bland suggests polygenic analysis of SNPs and family of methylation related genes; tissue-specific genomic methylation profile; genomic stability assessment; telomere length; metagenome analysis; inflammation biomarkers; oxidative stress biomarkers; and urinary polyphenol analysis. The future is personal and takes advantage of the tools and technology available to make the best recommendations for patients that they can adhere to.
While this revolution is still underway, the opportunities for practitioners and personalized interventions are endless.
“It truly is a remarkable and epic time,” said Bland.