the impact of vitamins and supplements presented by georgia tetlow, md march 13, 2013
TRANSCRIPT
The Impact of Vitamins and Supplements
Presented byGeorgia Tetlow, MD
March 13, 2013
2Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Disclosure/Disclaimer
Disclaimer• Information is intended for educational purposes only,
not as medical or psychological advice or treatment
Nothing that isn’t disclosed– I have an online store that benefits educational
programs– Monthly educational webinars
3Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
• Integrative Medicine• Key research pearls• Vitamin D• Omega 3’s• Dairy• Soy
• Lifestyle choices– Smoking– Weight– Alcohol– Green tea– Emotional/spiritual
health, social connection, mindfulness
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974 4
Agenda
The Impact of Vitamins and Supplements
Integrative Medicine
• Combines best of conventional medicine– Cancer fighting drugs, therapies, surgery
• With additional safe, effective approaches, treatments• Evidence-based = standard for medicine• JUST GOOD MEDICINE
– Need provider who is open to all the evidence and who is trained
5Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Integrative Medicine continued…
• Biological interventions– Vitamins and Supplements– Whole Food diet
• Mind-Body Medicine• Alternative Medical Systems
– Traditional Chinese Medicine, Ayurveda, Homeopathy• Energy Medicine
– Acupuncture• Hands-On medicine
6Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
“Integrative medicine honors the innate ability of the body to heal, values the relationship between patient and physician, and integrates complementary and alternative medicine to support the organism and facilitate healing.”
---Victoria Maizes, MD, Executive Director
University of Arizona Center for Integrative Medicine
Integrative Medicine
7Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Why Integrative Medicine?
• Patient at the center• Addresses the full range of physical, emotional, mental, social,
spiritual and environmental influences• Personalized strategy that considers the patient’s unique conditions,
needs and circumstances• Health as “a state of complete physical, mental and social wellbeing
and not merely the absence of disease or infirmity.”*
*Constitution of the World Health Organization — Basic Documents, Forty-fifth edition, Supplement, October 2006.
8Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
About Georgia Tetlow, MD
• Graduate Fellow, University of Arizona Center for Integrative Medicine
• CEO, Founder of Philadelphia Integrative Medicine• Clinical Assistant Professor of Rehabilitation Medicine
Thomas Jefferson Medical College• Yoga Teacher for 20 years• Mindfulness teacher
9Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974 10
The Impact of Vitamins and Supplements
Your Plate
11Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Your Plate• No one food ingredient
– Eat from the rainbow– Broccoli/cabbage family
• Indole-3-carbinol– Supports immune system, reduces cellular damage
balances hormones– Collards, mustard greens, turnips, cabbage, broccoli,
kale, cabbage, cauliflower and Brussels sprouts• Food choices for healthy weight• 5 or more servings of vegetables and fruit daily
12Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Antioxidants
• Reduce inflammatory and toxic cell mediators– NFkB, Il-6, Il-8
• Donate electrons to electron-deficient free radicals– Neutralize them!– Cells and DNA protected, help prevent cancer
13Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Why Supplements, Anyway?
– Strengthen the immune system– Reduce inflammation– Reduce free radicals– Reduce DNA damage that leads to cancer
14Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Pearl 1
• Whole foods and healthy diets should be the primary approach in designing studies to test nutrition-cancer associations
• Experts believe components in many foods, especially fruits and vegetables, act synergistically to reduce cancer risk
15Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Pearl 2
• Seek products that most closely mimic the forms that nutrients naturally take in food, such as vitamin E in the form of mixed tocopherols and tocotrienols or vitamin A in the form of mixed carotenoids (vs. β-carotene alone or vitamin A palmitate)
• Dosage, duration and quality matter
16Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Pearl 3
• The greatest benefit from taking supplements of any kind seems to be for those who are deficient in a particular nutrient
"Diet, anthropometric measures and prostate cancer risk: a review of prospective cohort and intervention studies." Dagnelie PC, et al. BJU international 93(8):1139-50 May, 2004
17Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Pearl 4
• Genetic differences contribute to individual variation in response to foods and nutrients
• Genetics influence the rates of absorption, metabolism and sites of action of individual constituents
• Unmeasured, uncharacterized gene variation likely explains inconsistent findings across studies and across different populations
Milner, JA. "Incorporating basic nutrition science into health interventions for cancer prevention.” The Journal of nutrition 133(11 Suppl 1):3820S-3826S Nov, 2003
18Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Vitamin D3 (Cholecalciferol)
• Hormone• Controls phosphorus, calcium and bone metabolism and
neuromuscular function• The only vitamin the body can manufacture from sunlight• More and more people deficient due to indoor living,
heliophobia and sunscreen use
19Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
• Approx. 1 billion* may be Vitamin D3 deficient• Dark skin, obesity, heredity may hinder production• Elderly may need more D3 (decreased skin, renal
synthesis)• Test: 25 (OH) Vitamin D
– <30 ng/mL insufficient– 45 ng/mL adequate– 60-80 ng/mL more optimal
*world wide 20Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
Vitamin D3 (Cholecalciferol) continued…
The Impact of Vitamins and Supplements
Vitamin D3 continued…
21Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Fats, Omega 3’s• Cook with Olive Oil • FISH OIL (Omega 3’s fatty acids)
– modulate estrogen metabolism, estrogen receptors
– Must be triglyceride– 1-3 grams daily, with food, discuss with
doctor– mercury/toxin free– many benefits– thins the blood
22Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Fish Oil Slows Tumor GrowthHardman, J. Nutr. 132:3508S-3512S, 2002
23Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Dairy
• Over 36 case-control plus 10 prospective cohort studies showed inconsistent findings
• Recent pooled analysis of American and European cohort studies found no association with dairy and postmenopausal breast cancer
Moorman PG, et al. "Consumption of dairy products and the risk of breast cancer: a review of the literature." Moorman PG, et al. The American journal of clinical nutrition 80(1):5-14 Jul, 2004 Missmer SA, et al. "Meat and dairy food consumption and breast cancer: a pooled analysis of cohort studies." International journal of epidemiology 31(1):78-85 Feb, 2002
24Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Dairy continued…
• Dietary calcium and low-fat dairy products associated with a moderately lower risk of postmenopausal breast cancer compared with women with lowest intake levels
• Supplemental calcium or higher levels of total calcium (diet plus supplements) were not related to overall breast cancer risk
Moorman PG, et al. "Consumption of dairy products and the risk of breast cancer: a review of the literature." Moorman PG, et al. The American journal of clinical nutrition 80(1):5-14 Jul, 2004 Missmer SA, et al. "Meat and dairy food consumption and breast cancer: a pooled analysis of cohort studies." International journal of epidemiology 31(1):78-85 Feb, 2002
25Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Soy• Soy beans and fermented soy bean products such as tofu,
tempeh and soymilk• Case-control studies support a protective effect of soy in the
breast– case-control study among Korean women stratified by
menopausal and hormone receptor status of the tumors• significant 64% reduction in breast cancer risk (95% CI
0.20, 0.64) with higher soy consumption
Cho YA, et al. "Effect of dietary soy intake on breast cancer risk according to menopause and hormone receptor status." European journal of clinical nutrition 64(9):924-32 Sep, 2010
26Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Soy continued…
• This association may not only result from higher intake of soy but also in utero and early exposure and pre-pubertal and adolescent exposure during mammary gland development
• In addition, soy intake among Asian women is strongly correlated with increased consumption of fruit and vegetables
Butler LM, et al. "A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women." The American journal of clinical nutrition 91(4):1013-9 Apr, 2010
27Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Soy Conclusions
• Moderate amounts in diet are safe and likely protective• Half serving a day servings per day• May not be advisable in advanced stage breast cancer
as early evidence from cell culture studies suggest possible proliferative effect in the setting of metastatic carcinoma
Messina M, et al. Can clinicians now assure their breast cancer patients that soy foods are safe? Women's health (London, England) 6(3):335-8 May, 2010Martínez-Montemayor, et al. "Individual and combined soy isoflavones exert differential effects on metastatic cancer progression." Clinical & experimental metastasis 27(7):465-80 Oct, 2010
28Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Cancer: Factors Within Your Control
• Smoking• Weight control/Exercise• Diet
– Alcohol– (Fruits/vegetables, best fats, certain cancers: hormones in beef and milk)– Green tea
• Omega 3 Fatty Acids
• Vitamin D—get tested!• Healthy immune system—emotional and spiritual health, social connection
29Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Breast cancer prevention: 1 drink daily or less
Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974 30
The Impact of Vitamins and Supplements
Mind-Body Interventions -Mindfulness
31Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Mindfulness Literature
• Witek-Janusek, et al (2008). Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain, Behavior, and Immunity, 22(6), 969-981.
• Carlson, et al (2007). One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain, Behavior, and Immunity, 21(8), 1038-1049.
32Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
“Integrative medicine addresses the root causes of illness and suffering. These root causes involve many aspects of a person’s life, including the physical, but also the psychosocial, emotional, and spiritual dimensions as well.”
--Dean Ornish, MD Founder and Director of the Preventive Medicine Research Center
33Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Return to Art of Medicine
• Mind, Body and Spirit• Fight cancer, but focus is on health and returning to
health• Power of life style choices!
– Understand root causes
34Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Philadelphia Integrative Medicine offers a comprehensive approach to health and healing which recognizes the whole person, and champions self-care for health, illness recovery and prevention through education, inspiration and empowerment.
Mission
35Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
4wholeness.com
An online community and resource for women with breast cancer who want information about how to integrate natural and holistic therapies with allopathic cancer treatment.
If the HPERLINK above doesn’t work, copy and paste this link into your Internet browser: http://vimeo.com/28516754
Upcoming Webinar
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• Webinars: less than $20
37Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974
The Impact of Vitamins and Supplements
Thank you!
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38Georgia Tetlow, MD - Philadelphia Integrative Medicine – www.philly-im.com - 888-702-7974