paula nenn - quantified self san diego
DESCRIPTION
Slides which accompany the talk Paula Nenn gave to the Quantified Self San Diego GroupTRANSCRIPT
Translating Advanced Science into Personalized
Health and Wellness
Paula J Nenn MD
Senior Medical Director
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
Who? What? Why?
• 501c3 Non-profit research foundation
• Formed 2 ½ years ago, San Diego based
• Self-care and personal health accountability key to US
economics
• New science – 800 articles per DAY!
• Public Interest in all things ‘alternative’
• New science – personalized medicine, genomics, systems
biology, early predictive biomarkers
• Personal health tracking devices
• Bring it all together into one program?
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O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
‘New’ science
optimalhealth
sub-optimalhealth
pre-disease
chronicdisease
Insulin resistance
Cardiometabolic
Syndrome
Pre-DiabetesDiabetes
Hyperinsulinemia
Diabetes Complications- Leg Amputations
- Kidney & Heart Disease
- Erectile Dysfunction, …
- Blindness
Sta
nd
ard
Am
eri
ca
n D
iet
clinical diagnosticthreshold of disease
conventional diagnosticspreventive / predictive functional assessments
EARLIEST SUB-CLINICAL IMBALANCE AND RISK FACTOR BIOMARKERS
EA
RLY
DE
TE
CT
ION
CHRONIC DISEASES
NEVER JUST HAPPEN
TO YOU, THEY ARE THE
END RESULT OF A
LONG, PROGRESSIVE
DECLINE.
DYNAMIC CONTINUUM
3
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
Tree of Health and Disease
CARDIOLOGY
ENDOCRINOLOGY
NEUROLOGYGASTROENTEROLOGY
PULMONOLOGY
IMMUNOLOGY
ONCOLOGYPSYCHIATRY
Functional Imbalances
Systemic Inflammation
Oxidative Stress
PRE-DISEASE
SUB-OPTIMAL HEALTH
Clinical Diagnostics
EMOTIONAL & MENTAL
BALANCE AND
STRESS RESILIENCE
MACRO & MICRO
NUTRITION
SLEEP,
CIRCADIAN RHYTHMS
& RESTORATIONPHYSICAL ACTIVITY &
STRUCTURAL BALANCE
MICRO ENVIRONMENTAL
PROTECTION
SPIRITUAL &
SOCIAL BALANCE
‘ENERGY SYSTEM’
BALANCE
Functional Assessment Biomarkers
Genetic Predispositions( gate-keepers )
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O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
Optimal Health and Prevention Program
EMOTIONAL & MENTAL
BALANCE AND
STRESS RESILIENCE
MACRO & MICRO
NUTRITION,
AIR, WATERSLEEP,
CIRCADIAN RHYTHMS
& RESTORATIONPHYSICAL ACTIVITY &
STRUCTURAL BALANCE
MICRO ENVIRONMENTAL
PROTECTION
SPIRITUAL &
SOCIAL BALANCE
‘ENERGY SYSTEM’
BALANCE
Functional Assessment
Biomarkers
roots & trunk
OHPProgram
Optimal HealthGPS
Comprehensive Predictive,
Preventive Functional
Biomarker Assessment
OHP Dx
1
Personalized, Integrative Self-
care Recommendations
OHP Rx
3
Ongoing Educational,
Optimal Health Coaching and
Progress Monitoring Support
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1
2Translational Algorithm &
Artificial Intelligence
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Genetic Predispositions
( gate-keepers )
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O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
Demonstration Project
• 100 subjects chosen from volunteers
• Age, gender, ethnicity matched
• Each acts as their own control
• Start Spring 2011
• In collaboration with Scripps Center for Integrative
Medicine
• Age ≥ 18
• Exclusion criteria: acute illness, pregnancy
• Current chronic illness not an exclusion criterion but must
be stable
• Consent from primary physician
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O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
Registration,EHR &
Questionnaires
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Week 1
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
Urine & Blood Tests&
questionnaires
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Week 1: Blood and Urine tests
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
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SNPs(Genomic Saliva
Panel)& questionnaires
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Week 2 - Genetics
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
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2
24-hr ABPM24-hr Holter
Saliva Cortisol + DHEA& questionnaires
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Week 3 – Autonomic Nervous System
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
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2
3
Sleep AssessmentEEG + Oximetry& questionnaires
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Week 4 - sleep
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
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2
3
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Physical ActivityFood Diary, FFQ
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Week 5 & 6: Caloric Balance, Sleep Actiography
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
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Physical Tests(Onsite)
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Week 7: Non-Invasive Physical Tests
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
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2
3
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Integrative MD Consult
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START…
Week 8: MD and coach
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
Week 8: Start Program
• Personalized Interventions
• Nutritional recommendations
• Physical activity
• Breathing
• Sleep
• Environmental toxicity
• Stress
• Energy medicine
• Spirituality / connections / gratitude15
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
1
2
3
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Interim Data Analysis
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Week 12
Week 26
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
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Final Data Analysis
2012
Week 52: Program Finish
O p t i m a l H e a l t hAND PREVENTION RESEARCH FOUNDATION
Biomonitoring
• Assessment Phase
• 24 hour HRV
• 24 hour AMBP
• 2/52 Body Media – calorie balance, sleep
actiography
• 3 day Apnea link sleep apnea screening
• Zeo Sleep Monitor 7/7
• Text and IVR food diary
• Intervention
• Body Media
• Zeo
• Emotional sampling
• Biofeedback devices: meditation, HRV etc18