The Misperception Of Illness - Can Personalized Medicine Prevent Disease?The Misperception Of Illness - Can Personalized Medicine Prevent Disease?

nbj: Why did you write this book?

Jeff Bland: We are witnessing an epidemic increase in chronic disease, and the “pill for an ill” approach of pharmaceutical medicine is not successful in managing the crisis. The solution to the problem resides in implementing the new science of personalized lifestyle healthcare. This book describes how to apply this revolutionary new science.

nbj: What new insights about health & wellness did you glean through writing this book?

Bland: Traditionally, medicine has focused on the diagnosis of the disease as the principle objective. The treatment is designed to manage the symptoms or effects of the disease. The breakthrough science of the past fifteen years is in understanding the cause of these major chronic diseases. The book provided me the opportunity to bring these discoveries about the origins of chronic disease to the reader so that a personalized program can be designed for the treatment of the cause and not just for the treatment of their symptoms. The major insight here is that chronic disease starts as alterations in physical, physiological and psychological function that result from imbalances between a person’s lifestyle, diet and environment and their genetic uniqueness. This discovery allows for early warnings into the disease process, and the ability to design and implement a personalized lifestyle medicine program to treat the condition before it becomes more serious.

nbj: What role could supplements play in a more personalized approach to medicine?

Bland: A personalized dietary supplement program is a cornerstone for the development of a successful health outcome. Every person has a genetic uniqueness where they are advantaged by taking one or more specific dietary supplements. The key is to know what supplements are required for the individual. The book provides a suggested approach to personalizing the nutritional supplement program based upon the revolutionary, 21^st-century genomic and epigenomic science.

nbj: What most excites you about the broader adoption and awareness of genomics and microbiomics in clinical practice?

Bland: I feel that breaking the chronic disease process into an understanding of the seven core physiological imbalances that I describe in the book allows the reader to better understand how genes, environmental health, and disease interact. From this approach, an understanding of the role of the gut microbiome, epigenetics, and translational genomics can be developed. The payoff from this approach is the ability to design a personalized lifestyle healthcare program for the person that will improve both their functional heath and their long-term healthspan.

nbj: As a student of medical history, how rapidly should we expect medicine to change? Should we feel impatient to see that change?

Bland: It has traditionally taken approximately 50 years from the time of a major medical discovery and its implementation into usual clinical practice. With the advent of the internet, however, this timeline has been significantly compressed. With the present need to find a solution to the chronic disease epidemic, I believe that the concepts of functional medicine that I describe in the book—and its application to personalized lifestyle healthcare—will occur within the next five to 10 years.

—marc brush

     The following is excerpted from the introduction to The Disease
Delusion by Dr. Jeffrey S. Bland, published earlier this year by
HarperCollins.

     Complex and common, with numerous hard-to-specify causes but no single origin, chronic illnesses are increasingly conditions we have to live with. More and more of us are doing so, and it is an expensive proposition. In fact, unless we can implement drastic change, the numbers tell us we are all on a headlong course toward a frail, sick old age in which we will spend much of our time going to doctors and popping pills.

     It doesn’t have to happen. As you’ll learn in the pages that follow, dramatic scientific discoveries have put in our hands the power to avoid the collision with debilitation and illness, setting the stage for a veritable revolution in health care. We can now identify the causes of chronic illness in an individual, and using the approach described in this book, we can then put an end to the illness; even better, we can identify the causes of a chronic illness before it becomes a disease and avert it through early intervention. This is transformational. It is equivalent to the paradigm shift in medicine brought about by the discovery of immunization and antibiotics

for the management of infectious disease. I call it the “functional medicine revolution.” And for the past forty years, as a researcher in biological and clinical sciences and a medical educator, I have been in the forefront of the effort to bring it about.

     What do I mean by “functional medicine”? As you know, your body is a network of systems. We speak of the circulatory system, the digestive system, the nervous system, the endocrine system, the immune system, the reproductive system, the respiratory system—the list goes on. Each system is composed of organs that work together to perform a biological function: the heart and blood vessels of your circulatory system pump blood to your body; the brain, spinal cord, and nerves of your nervous system receive and process information that tells your body to do various things; the lungs, bronchi, and larynx of your respiratory system send oxygen throughout your system to keep your body operating. It takes a lot for each of these systems to continue to work smoothly and at peak performance. In addition, the systems interact with one another via complex networks; this adds yet more intricacy to the dynamics of all the biological functioning going on. So when we think about how our bodies work— something we usually do when they’re not working very well—we ought to be thinking about how the component parts of these systems relate to one another and to all the other systems.

     Yet our current medical model—the way health care professionals are trained and the strategy of therapy they apply—is not based in such systems thinking. Precisely because it derives from the germ theory, it is based in reductionist thinking: find the bug and nuke it with a drug developed for just that purpose. Period. As brilliantly as the model works in providing acute care, it clearly does nothing to restore or maintain balance among functional systems or the networks that connect them.

     But functional medicine does exactly that. It looks at the patterns of dysfunction underlying the chronic diseases that are shadowing all our lives, and it offers a model of care that can prevent or reverse these illnesses. How does that model of care work? You’ll learn more about it in subsequent chapters of this book, but suffice it to say that it is based on the way our genes are stimulated by and respond to what is going on around us and the kinds of behaviors we practice. Basically, if we can change the latter—our environment and our behavior—we can change the former. That is, we can change the way our genes get stimulated and the way they respond, and since genes regulate or direct our biological functions, that can also change our pattern of health.

     This is new science. It comes out of the genomic revolution that is rewriting our understanding of how our genes form our individuality, of how we get from genotype to phenotype, from the latent genetic possibilities we’re born with to the unique individuals we become, sporting the particular observable characteristics that make us who we are. The new science tells us that this does not happen according to a fixed blueprint incised at conception into our genes; rather, it happens because of the way our genotype interacts with

our environment, stimulating responses in our core physiological processes throughout our lifetime.

     So profound a change in understanding surely requires a new model of medical care, one focused on that interaction and on how and how well those core processes are functioning. That is what functional medicine does. Where the standard medical model addresses the symptoms of illness and focuses on coming up with a diagnosis, and where integrative or alternative models offer a cafeteria list of historical healing approaches to health problems, functional medicine accesses the newest scientific biomedical discoveries to focus on the underlying causes of an individual’s health problems.

     Compellingly, functional medicine matches those discoveries and technologies against the health issue of our time—chronic illness—as it searches for underlying causes in the interaction between the individual’s genetic uniqueness and his or her lifestyle, environment, and diet. Functional medicine then engages patient and practitioner in designing a personally tailored health-management program that couples pharmaceutical science, where necessary, with changes in the patient’s environment, diet, and lifestyle—not just to bring relief to the individual but to realize his or her full genetic potential for vitality and longevity.