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IgelosaHome of

Wellness by oriflame

sTIg sTeeN

“Robert af Jochnick and I met through a common friend of ours, Professor Sven-Olof Isacsson, and we began our cooperation on “Wellness by Oriflame” in 2006. Robert and his brother Jonas are both well oriented within the field of medical physiology and they follow the development of the biosciences with great interest. It has been a privilege for me to get to know them and their families and to recognize them as my friends”.

Stig SteenProfessor of Cardiothoracic Surgery Lund University

2 IGELOSA Home of Wellness by Oriflame 3 Stig Steen

© 2012 Igelosa Life Science ABwww.igelosa.com

Published by: Oriflame Sweden ABAddress: Box 1095, 101 39 Stockholm, SwedenPhone: 08-58632300Photographers: Stig-Åke Jönsson, Matthew Pohl, Lennart Romberg, Ådne Steen, Björn Wohlfart, Peter Zacharewicz, iStockphotoPrint: xxxxISBN: xxxx

Copyright © 2012 Igelosa Life Science AB. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior consent of the publishers.

Oriflame Sweden AB is not responsible for the content in this book. The opinions expressed by the author do not necessarily reflect the opinions of the publisher, nor its employees.

Lund University as a matter of policy does not endorse specific products or services. Professor Steen’s credentials are for identification purposes only.

All patient stories in this book are examples from real-life. The names have been changed.

IGELOSAHome of

Wellness by Oriflame

BY STIG STEEN

FOREWORD

In my entire life as a doctor I have dealt with severely ill patients and their relatives. During the last five years I have also had the privilege to meet Oriflame consultants and employees from sixty different countries. I am overwhelmed by the generosity and love that I have encountered everywhere and from everyone. To show my gratitude I have written this book in the hope of promoting health and wellbeing for all my friends within Oriflame.

Sincerely yours,

Stig SteenProfessor of Cardiothoracic SurgeryLund University

With grateful support from Hans Gabriel and Alice Trolle Wachtmeister’s Foundation for Medical Research


CHAPTER 1. The fragility of life 15CHAPTER 2. A personal awakening 21CHAPTER 3. Longevity and happiness 27CHAPTER 4. History of the Natural Balance Shake 35CHAPTER 5. Inside the WellnessPack 41CHAPTER 6. The Natural Balance Soup 47CHAPTER 7. “Mother’s meatballs” 55CHAPTER 8. The Okinawa Program 59CHAPTER 9. Okinawa at Igelosa 63CHAPTER 10. Food and physiology 67CHAPTER 11. Overweight and obesity 71CHAPTER 12. A physiological revolution 75CHAPTER 13. Igelosa kitchen insights 87CHAPTER 14. On love and life 99

IGELOSAHome of

Wellness by Oriflame


ABOUT THE AUTHOR

Name: Stig Joar Steen Date of birth: 1948-02-07 Place of birth: Tynset, Norway

In 1997, Stig Steen was appointed professor of cardiothoracic surgery (heart and lung surgery) at Lund University, the largest university in Scandinavia. Besides Norway and Sweden, Steen has worked in the USA and as a volunteer surgeon in Africa. During the past two decades he has been involved in scientific cooperation with leading university hospitals in the P.R. China, where he is currently honorary professor at three different universities.

Specialty qualifications:• Medical Degree 1974• General surgery 1981; Cardiothoracic surgery 1988• Associate Professor of Surgery, Lund University 1987• Professor of Cardiothoracic Surgery, Lund University 1997• Honorary Professor in PR. China: Henan Medical University 1997; Zheng Zhou University 2000; Xinqiao Chongqing Medical University 2001

Inventions:• LUCAS® automatic chest compression device (www.lucas-cpr.com)• STEEN-Solution™ for ex-vivo lung perfusion, EVLP (www.vitrolife.com)• Vivoline LS1™ System for EVLP (www.vivoline.se)• Developer of the Natural Balance Shake and the Natural Balance Soup

Stig Steen lives in Lund, Sweden, with his wife, Ellen. They have five grown up children.

Stig Steen is instructing visiting surgeons from USA and Japan how to repair damaged lungs ex-vivo (outside the body) prior to lung transplantation. This revolutionary method was developed by Stig Steen and is described in The Lancet (2001; 357:825-829).


IGELOSA LIFE SCIENCE COMMUNITY:The research centre is located on the open plains that surround the university city of Lund, in southern Sweden. Scientists travel to Igelosa from all over the world to learn about new therapies that are being developed here. During the visits, researchers can stay at the centre and take all meals in the dining hall together with patients and staff members – at Igelosa they become part of a community.


A regular day atIgelosa


In October 2010 H.M Queen Silvia of Sweden visited Igelosa Life Science Community, the home of Wellness by Oriflame.

14 IGELOSA Home of Wellness by Oriflame 15 Stig SteenCHAPTER 1

FRAGILITYof life

The


I began my studies in medicine in 1968, the year of the student revolutions. These protests also affected my student life in Bergen, Norway, where I studied. The revolution movement at that time was inspired by Marx, Lenin and Mao, figures who were iconic of a world hoped to be liberated from social injustices. I was young, strong and optimistic about what life had in store for me.

In the fall of 1970, after two years of pre-clinical studies, my fellow classmates and I were given the possibility of working as nursing assistants with seriously ill patients. I applied and was assigned Saturday night duty at the department of surgery. Here I was immediately confronted with a reality for which I was not prepared. One of my first patients was a 33-year old woman who did not have any family members in town. She was a cancer patient whose right breast had been removed the previous year. Six months later she also had to remove her left breast. Despite radiotherapy and chemotherapy, the cancer had spread to her liver and lungs. This time she had been admitted to the surgical department for yet another relieving operation.

I was shocked when I first saw her. She was very thin, her complexion was yellowish and she had lost all her hair. My job was to assist her and to keep her company for the next twelve hours. The instructions I received from the busy nurses were to keep her warm and dry, as she perspired a lot. During the first two hours there was no contact between us, even though she was awake. I kept busy turning her around in bed, changing her wet gown and moisturizing her lips. Eventually I could see that she appreciated my care. Around midnight she grasped my hand, gave me a little smile and fell asleep. I must also have fallen asleep for a while but was suddenly awakened by a strange sensation; her hand was inert and cold in my hand. After rushing for help, a nurse came and declared her dead, which was later confirmed by the on duty physician. I had to return home to a sleepless night.

This was a new kind of reality for me. I soon learnt that this kind of human suffering was part of daily life at all major hospitals, where seriously ill patients are admitted in the hope of being rescued back to life. I began to question myself. Did I really have what it takes to be a physician? One of my best friends, a classmate who also watched over dying patients, later committed suicide by taking an overdose of sleeping pills. Two fellow students, who saw how lost I was, included me in their circle of friends. Shortly thereafter I met an operating room nurse who later became my wife. Our relationship and the family of five children we formed saved me from a serious existential depression. I realized that the most important questions in life cannot be answered by politics or natural science. As important as these activities andinstitutions are, they cannot satisfy the deepest human longings in life.

CHAPTER 1. The fragility of lifeCHAPTER 1 The fragility of life


Anna, 56 years old: the miracles of hope and emotional support

IGELOSA Home of Wellness by Oriflame Stig Steen

Anna started to smoke in her teens. She was now on sick leave from her position as a division manager at a mid-sized company, where she worked long and stressful hours. Periodically, she smoked up to forty cigarettes a day “in order to cope with it all”. Anna was the only child of now deceased parents. She had been married once but after five years of unsuccessful attempts to have children, her husband asked for a divorce. In the following years she worked even harder. Over the past four years Anna had developed chronic obstructive pulmonary disease (COPD), a severe lung disease. She was now confined to a wheelchair and dependent on supplemental oxygen from a mask. This was her condition when I met her for the first time, in order to assess the possibility of a lung transplant.

Anna was very thin. She had yellowish fingers and smelled of tobacco, which was a sure sign that she was still smoking. She had grey hair and her face was wrinkled and pale, except for her blue lips. She had that laboured expiration typical of COPD patients. Besides her decreased lung capacity, all other tests indicated normal levels, meaning she was qualified for a lung transplant. Anna, however, did not want to live any longer. She blamed herself for the disease and believed that she only got what she deserved. Anna had nothing else to look forward to at this stage. She had come to see me only reluctantly after being persuaded by the lung specialist in her hometown.

Anna’s attitude was typical of many COPD patients. They are often in despair and have very little to look forward to. Every breath is a struggle, so frightening to witness, that often their own family, friends or colleagues cannot endure being in their presence. These patients are often left alone, with their only faithful companion being an oxygen mask and their fears of slowly suffocating to death. Considering Anna’s state of mind, it was not advisable to put her on the waiting list for lung transplantation. Instead she was hospitalized and enrolled in a rehabilitation program, in the hope that she could find some new motivation. She was prescribed adequate nutrition and was even fed at night through a gastric feeding tube. A physiotherapist trained all the muscle groups which could be activated even minimally and I personally visited her regularly, sometimes several times a day. During my visits I tried to assure her that she could regain much of her health after a lung transplant.

It was sometime around Easter. I was on call the entire week and therefore I had more time than usual. I was just on my way to her room when a nurse suddenly hurried to inform me that Anna was just back from the hospital’s beauty parlour and that I should not fail to comment on her new hairdo. No, never! A little glimpse of hope had been lit. Anna could now be put on the waiting list for lung transplantation. After some time she received two new lungs without any post-operative complications. Anna could later return to her work, where she was warmly received by her colleagues.


PERSONALawakening

A


In 1999 the Swedish National Institute of Public Health published a report on the state of public health in Sweden. This report ranks the diagnoses that cause the most disease burden and early death in Sweden. The diagnoses are ranked according to the DALY measure system (disability-adjusted life-years). It measures the number of years lost due to illness, disability or early death. Swedish life expectancy statistics, among the highest in the world (83 years for women and 80 years for men), are used as benchmarks for measuring lost years and every individual contributes to the statistics. A person who has been on a one-year sick leave for coronary artery disease (CAD) contributes with one DALY to this diagnosis. And a man who dies of CAD at age 50 contributes with 30 DALYs to CAD (33 DALYs if it were a woman). The ten most frequent causes of disease burden and early death are shown in Table 2.1 below.

This information was a wakeup call for me. I knew that coronary artery disease was the major cause of death in Sweden as it is in the entire Western world, where it is causing almost a third of all deaths. I have performed thousands of coronary bypass operations and carried out many heart transplantations on patients suffering from heart failure after CAD. What surprised me in the statistics was the high incidence of mental suffering, including self-mutilation and suicide. According to the World Health Organisation (WHO) similar statistics is seen on a global level, where five of the ten leading causes of disability are psychiatric conditions.

My medical perspective, which had so far been mainly surgical, widened and I began to study lifestyle factors that contribute to a patient’s disease (see Table 2.2). For this purpose Igelosa was built as a medical clinic with guest rooms and a fully staffed kitchen, so that patients could be included in the research on a daily basis.

The good news is that most of these risk factors can be reduced, or even eliminated, by an adequate lifestyle change, combined with medical treatment when needed. Then, even for people with a genetic disposition for disease, normal life expectancy may be obtained. When looking at the DALY table, it is striking how much suffering is due to mental disorders. The importance of good relationships for our health cannot be overestimated.

CHAPTER 2. A personal awakeningCHAPTER 2 A personal awakening

MEN DALY (%) WOMEN DALY (%)

1. Coronary artery disease (CAD) 19.2 1. Coronary artery disease (CAD) 13.7

2. Depression and neurosis 6.6 2. Depression and neurosis 10.9

3. Stroke 5.8 3. Stroke 6.9

4. Alcoholism 4.5 4. Dementia 6.3

5. Self-mutilation and suicide 4.2 5. Breast cancer 3.1

6. Dementia 3.1 6. COPD1 + asthma 2.8

7. COPD1 + asthma 2.8 7. Psychosis (not schizophrenia) 2.6

8. Lung cancer 2.7 8. Back- and neck diseases 2.3

9. Traffic accidents 2.3 9. Respiratory infections 2.1

10. Psychosis (not schizophrenia) 2.3 10. Gynaecological cancer 2.0

1 Chronic Obstructive Pulmonary Disease

Table 2.1: Disability adjusted life years in Sweden

Table 2.2: Lifestyle related risk factors1. High blood pressure2. Smoking3. Bad blood lipids 4. High blood sugar (diabetes)5. Physical inactivity

6. Overweight7. Stress8. Sleep problems9. Alcohol overconsumption10. Social isolation


The opera singer, 60 years old: when the lights go out

She was very elegant and articulate. She came to the hospital in order to operate a recently discovered cancer tumor in her left lung. It had appeared after excessive smoking, following her retirement from a lifelong career as an opera singer. The examination showed that she had a minor tumor in an isolated part of her lung, but so far it had not spread. The conditions for radical surgery were therefore very good. The operation also went well, the tissue around the tumor was removed and the following tests confirmed that the operation was radical, i.e. all the tumor tissue had been removed. The patient, however, was deeply affected by the operation and in the following days she was very tired. In addition, she now gave the impression of being depressed. She asked me if I could contact her two sons who lived in other parts of Sweden and especially her daughter, who lived abroad and worked as a nurse to a world-famous liver surgeon. I knew this surgeon very well personally. The patient was divorced, but she wanted all her children to come and visit her at the hospital.

I phoned her sons and daughter and explained that their mother could now be considered cured from cancer and that she had one great wish: that they would come and visit her at the hospital. I received avoiding responses from all three of them. Apparently, it was not possible for any of them to come. I tried to explain this to the patient in the most merciful way possible, but I could see that she was very disappointed. On the eighth night after the operation the patient was found dead in her bed. The post mortem examination revealed massive blood clots in both lungs. This is a cause of death that is not uncommon for people who have lost all motivation to live and stay passively in the bed most of the time.

Siri, 90 years old: a mother of three and the power of family

An elderly woman arrived at the emergency room with a heart valve that was so narrow that it obstructed the blood from flowing out of the heart chamber. She had three daughters, all of whom were school teachers. I could see that they were very close to their mother. They followed her to the hospital to make sure she received the best medical treatment, insisting that all possible care must be done for her. The patient had previously been amputated and therefore had an artificial leg. Besides that, she had no other physical problems and was completely clear in the head. I decided to prepare for an operation. The patient was given a new heart valve and three coronary vessels to by-pass the ones that were blocked. The operation proceeded without complications, but afterwards the patient was very tired. Her daughters watched over her all the time, helped her with her food and encouraged her to recover. Within one month she regained strength and could return to her home, where her daughters continued to look after her.

Exactly one year after the operation, to the day, an elegant old lady entered the clinic. It was the same woman, now 91 years old, all dressed up and in excellent condition. This time she had come to pay the clinic a courtesy visit.

IGELOSA Home of Wellness by Oriflame Stig Steen


ANDhappiness

Longevity


CHAPTER 3. Longevity and happiness

I was standing in the spotlights on a stage in front of 10 000 Oriflame consultants in Kiev, Ukraine. One of them, a middle aged man, had just asked me a question. A murmur went through the hall, followed by complete silence. I was struck by the profoundness of his question. Time was short, my mind was on overload. How could I give a meaningful answer to this man? I could sense that his question was honestly meant and I knew my response had to be the same:

“Professor, how can I get a happy and long life?”

Since 1970 I have spent the majority of my professional life among severely ill patients and their families. All these encounters have affected me and shaped my view on life. Patients with severe diseases often open up and generously want to share their thoughts on life, suffering and death – but also their hope that even this part of life might conceal a deeper meaning. All this time, as a counterweight, I have been devoted to medical science.

When it comes to the science of longevity, many researchers have studied people who have retained their mental and physical health in advanced old age. Three things always stand out: adequate nutrition, daily physical activity and a good night’s sleep. But a long life is not necessarily a happy life. In this chapter we will look closer at what characterizes both a long and happy life.

Purpose: Each one of us is born with a unique set of genes: a potentiality of talents, ready to be actualized. Purpose is what gives meaning to life. It influences every decision we make: how we invest our time, spend our money, use our talents and value our relationships. Knowing the purpose of our acts helps us moving through the levels of happiness in life. These are happiness in things: food, clothes, a new car ; happiness in achievements: success at work, winning a contest, weight loss (if desired); happiness in belonging: to a family, friends, or a community; and ultimate happiness: truth, goodness, beauty. True goodness is always beautiful.

What is it that makes some people survive severe difficulties and others to give up their lives? Viktor Frankl (1905-1997), one of the world’s leading scientists in psychology and psychiatry, dealt with this question his whole life after having survived from Auschwitz. Those prisoners who were oriented toward a hopeful future, whether it was a special project to complete or a beloved person to be reunited with, were the most likely to survive the horrors of the labour camps. Frankl holds that man’s search for a purpose in life is a primary facet of his being; if the search is unrequited, it leads to neurosis, and this sickness of the mind can be overcome if the patient discovers purposefulness in his life. Happiness is always a side effect of finding your true purpose in life.

My own experiences from severely ill patients are the same: if they do not know their purpose, i.e. if they do not see a meaning with their lives, the chances of survival are not good. Helping a lost person finding his or her purpose in life is the best thing we all can do. And we should never forget that none of us can live well without receiving and giving back unconditional love.

Exercise: Both mental and physical exercise is vital. Even some months of mental inactivity may result in biological degrading of the brain. Any creative activity is therefore beneficial. Some examples include developing a business, travelling, learning to play a musical instrument, solving puzzles or crosswords and acquiring new hobbies such as cooking, singing in a choir or joining a book club. Even small mental exercises can improve the memory, and it is never too late to start practicing.

According to the WHO, all healthy adults should do at least 150 minutes of accumulated moderate physical exercise a week, unless specific medical conditions indicate to the contrary. This can be done by performing activities in multiple shorter bouts of at least 10 minutes each, for example 30 minutes of brisk walk five days a week. For additional health benefits, for example

CHAPTER 3 Longevity and happiness


weight loss and higher level of cardiopulmonary performance, adults should double the level of accumulated moderate physical exercise to 300 minutes per week. In addition to this, stretching for basal flexibility and weight training two times a week is recommended. Besides strengthening the muscles and skeleton, using free weights will also improve balance and thereby help prevent potential bone fractures from falling.

Relationships: Loyal friends are irreplaceable whereas bad relationships poison life and may endanger health. The golden rule is to treat every person we meet as we ourselves would like to be treated. Friendships need to be actively cultivated: do not wait for others to take contact, but reach out to them. If there are ongoing conflicts with other people, try to take the first step to work them out – and learn to forgive – for your own health’s sake. Chronic bitterness is highly destructive for the health and quality of life. A little smile to everyone you meet can open up many doors to a rich and meaningful life.

Sleep: We spend about a third of our lives in bed. During deep sleep, high levels of growth hormone are secreted while stress hormones are at their lowest level. This is important for the body’s regeneration and constant production of billions of new cells every day (see chapter four). Six to eight hours of sleep every night is associated with good health. Four helpful rules are: to get an adequate amount of sleep every night, to establish a regular sleep schedule, to get continuous sleep and to make up for lost sleep.

Omission: Some things in life need to be left out. Cigarettes and too much alcohol are obvious examples. Avoid contaminated air, especially tobacco, and do not sun tan too much. Do not drink and drive. Stress is a very common condition, especially among young people. Too much stress can lead to chronic disease or depression if not properly addressed. Make priorities, learn “the power of no”, i.e. to say no to meaningless things or doings. With good planning much negative stress can be avoided. Make it a high priority to have

a peaceful time before going to bed in the evening. Get rid of everything that can prevent you from a good night’s sleep (TV/computer). Mind the volume in your stereo and avoid overloading your brain with too much input from the Internet.

Nutrition: Animals that are given caloric restricted food significantly prolong their living age. There is general agreement among experts that complete nutrition without unnecessary calories is important for longevity also for humans. We will continue to discuss the importance of healthy nutrition in the following chapters and in chapter eight we will look closer at the food habits of the native population of Okinawa – the oldest and healthiest people in the world.

Attitude: “Optimists win in the long run”. Keeping a positive attitude is important in many ways. Positive thinkers tend to avoid depression, which is a well-known factor that can shorten the lifespan (remember the DALY table presented in the previous chapter). In a twenty-year study performed at Yale University, people who considered their ageing as something positive lived, on average, seven and a half years longer than people who considered their ageing to be negative.

Authors of bestselling motivational books have identified other attitudes that are important: courage: I have nothing to fear ; enthusiasm: life is exciting; peacefulness: I don’t need to worry; confidence: I can change for the better ; expectance: I have a future; and gratitude: I appreciate what I have. Another study showed that keeping a hopeful attitude can play a decisive role in helping accident victims and catastrophe survivors to regain their physical and mental health. Here, again, the belonging to a caring and loving community is vital.

CHAPTER 3. Longevity and happiness


Peter, 71 years old: Life purpose as medicine

I had given a speech at a meeting of retired academics and professors. After my lecture I was approached by one of the participants, who asked me if we could talk in private. Peter, a former professor in the humanities, told me that he felt very tired and did not sleep well. He gave a very kind impression. He was thin and looked younger than his actual age. I offered to do a medical examination, including a sleeping test, to exclude any somatic illness. He appreciated this offer very much.

The medical data confirmed my expectations; Peter was in good health, his body was comparable to that of a 50-year old man. His sleeping test also indicated normal results. However, when I presented this good news he did not show any signs of relief or happiness. Instead, Peter informed me that he was a widower for the past four years and that his real problem was the following: When he woke up at 4.30 in the morning, he did not know what to do with the day ahead of him. He did not have any meaningful tasks to do and nobody requested his advice or knowledge in his academic discipline. The days seemed endlessly long. I asked him about the neighbourhood where he lived, about his neighbours and the people around him. He did not have any children. I advised him to fill some thermoses with coffee and tea in the morning, to prepare some snacks, and then to visit elderly shut-ins and other lonely people in his area:

“Peter, you are a truly charming person and have this aura about you. I always feel good in your presence. I challenge you to do as I say. You will be the most sought-after person in your community and you will never wake up again without knowing what to do.”

When I looked at him again, tears were flowing down his cheeks. He did not say anything, but he gave me a warm embrace. He had been given a glimpse of hope, which is something we all need from time to time in order to embrace tomorrow.

Putting it all together: PERSONA By combining the first letter of each of the seven key-words into one word, PERSONA, we unveil the very foundation of a long and happy life. The word persona (from Latin: per = through and sona = sounds) originally means “through sounds”, i.e. through language. It is only with other persons that we can communicate in a meaningful way through language. And it is by showing goodness to every person we meet that we ourselves will maximise our experience of true lasting love and joy.

These insights may be valuable for Oriflame consultants, whose success is greatly dependent on their ability to establish good relationships. The seven characters in PERSONA: purpose, exercise, relationships, sleep, omission, nutrition and attitude are easy to remember and practice among family and friends.


CHAPTER 4

NATURALBALANCE SHAKE

History of the


Every day the body renews itself by producing billions of new cells. Each cell is an extremely complex living organism and has thousands of different functions that need to work in harmony with the entire body system. In order for this remarkable process to function we need to breathe air, drink water, eat food and sleep. When something essential is missing in the body system, we experience a dysfunction – a dis-ease – and then we do not feel so well anymore. When we supply what is missing, ease or “wellness” returns.

Severely ill patients tend to lose their appetite and often cannot eat enough food to supply the body with what it needs. I have faced this problem in my profession from the very beginning. A patient who quickly loses 20 % of the body weight cannot undergo major surgery because then the operation wounds will not heal properly. Patients with severe lung disease have yet another problem: their lungs cannot absorb enough oxygen from the air, which contains 21 % oxygen, so they need to breathe supplemental oxygen from a mask. Their lungs are so stiff that they cannot breathe out the carbon dioxide that their bodies produce. For these patients it is a matter of life or death that they get complete and optimal nutrition: not too much, not too little, just the optimal. If they consume too much fat or quickly-absorbed carbohydrate (sugars), these get combusted into carbon dioxide and water. Due to the already increased concentration of carbon dioxide in the blood, a further increase may cause the patients to become very tired, or even worse: it can drive them into coma.

The composition of the Natural Balance Shake was originally developed to give complete nutrition regarding protein, fat and slow carbohydrates to severely ill lung patients. It is composed of natural food ingredients that are slowly absorbed by the intestines and therefore give a stable blood sugar response, as well as a minimal increase of carbon dioxide in the blood.

CHAPTER 4. History of the Natural Balance Shake

When we began to investigate the effects of the Natural Balance Shake in healthy persons, many reported prolonged satiety and less sugar cravings. In 2007 we started to clinically document these effects further in our long-term research program for individual lifestyle change at Igelosa. Combined with exercise and dietary recommendations, mainly based on the principles from Okinawa, as well as coaching and follow-up on a regular basis, we noted good results in weight loss and other biological health markers. I will highlight some of these effects in detail in chapter twelve, in the remarkable story of Matthew Pohl.

Since the launch of the Natural Balance Shake, Oriflame has collected thousands of weight loss testimonials. The lifestyle and dietary advice they give in conjunction to the products are based on the scientific references in this book.

CHAPTER 4 History of the Natural Balance Shake

Natural Balance Shake ingredients include: pea protein, whole egg powder, whey protein (from milk), apple, rose hip and sugar beet fibre.


Natural Balance Shakes

SKETCH will add hires image


THEWellnessPack

Inside


Fish-oil capsules:Already in the 1930’s American scientists described the consequences of insufficient intake of essential fatty acids: loss of hair, eczema, skin pigmentation and growth disorder. The fish oil capsules of the WellnessPack contain the essential fatty acids. They are called essential because our bodies cannot produce them on their own. They must therefore be provided

from the food, for example by eating fat fish 2-3 times a week, or if this is not done, by taking fish oil as a supplement to ordinary food.

Vitamins and minerals:Walter Willett, MD, is chairman of the Department of Nutrition at Harvard School of Public Health and a professor of medicine at Harvard Medical School. In his bestselling book Eat, Drink and Be Healthy (2001) he has a separate chapter named “Take a Multivitamin for Insurance”. There is a risk today with our busy lives that our food habits also will suffer ; since vitamins are a type of nutrient that the body cannot make and must get from the food, there are studies suggesting that many people do not get enough of these essential nutrients.

Linus Pauling (1901-1994), the only individual to win two unshared Nobel Prizes, is widely regarded as one of the greatest scientists of the twentieth century. Pauling was awarded the 1954 Nobel Prize for Chemistry and the 1962 Nobel Peace Prize. He was also very interested in nutrition. In 1986 he published the book How to Live Longer and Feel Better in which he suggests avoiding sugar, stress and smoking, limiting alcohol, working in a job that you like and being happy with your family. To avoid serious illness and enjoy a

CHAPTER 5. Inside the WellnessPackCHAPTER 5 Inside the WellnessPack

longer life, Pauling recommends taking vitamins and minerals as supplements to the daily food to ensure that the body gets everything it needs to function optimally.

In 1973 Pauling co-founded the Linus Pauling Institute at Oregon State University, which investigates the role that vitamins, essential minerals and chemicals from plants play in human ageing, immune function and in preventing chronic disease. The book An Evidence Based Approach to Vitamins and Minerals (2003) gives an updated report on what this institute considers to be adequate and safe daily intake of vitamins and minerals for men and women of different ages. The vitamin and mineral content of the WellnessPack is based on these recommendations, which also comply with the official Nordic and European guidelines.

Antioxidants: The air consists of 21 % oxygen and without it we die within minutes. Oxygen in the body exists both in a stable and an unstable form. The unstable oxygen molecules are called “free radicals” and too much of them can damage our cells. There are plenty of antioxidants in ordinary food, especially in vegetables and fruits. The body also produces antioxidants. Air pollution, cigarette smoke, ultraviolet light from the sun, pesticides and contaminants in food, as well as stress and intense physical activity may produce excessive amounts of free radicals – sometimes more than the body can neutralize by itself. Important antioxidants are vitamin C, vitamin E, beta-carotene, selenium and astaxanthin – all of which are supplied by the WellnessPack.


WellnessPacks


TheNATURALBALANCE SOUP


Protein, fat and carbohydrate, aside from water, make up almost all the weight of food that we consume, with the remaining small amount being vitamins and minerals. Protein (from Greek: proteios = the first) is the most dominant of all nutrients. It makes up about 70 % of the dry weight of the cells. Proteins give structure to the tissue and function as enzymes, hormones, antibodies and transport molecules – all of which make life possible.

Proteins are constructed as long chains of hundreds or thousands of amino acids of which there are twenty different kinds. Eight of them are called essential because the body cannot produce them on its own. If we lack even one of these essential amino acids, the process of cell renewal will be slowed down or even stopped. However, for optimal nutrition all twenty amino acids are needed in sufficient amounts. Food proteins that contain a significant amount of all essential amino acids are referred to as complete protein. They are mainly found in animal products such as fish, egg, meat and milk. Most plant-based foods contain a little less of one or more essential amino acids. However, while a single plant-based food source may be lacking in one or more amino acids, a mixture of vegetables, grains, beans, legumes and nuts, will contain all of them. This is good news for everyone who, for any reason, does not consume animal products. It is also good for the environment since animal breeding requires much more natural resources than eating plant-based foods directly. Furthermore, a growing number of researchers and scientific institutions, among them Harvard School of Public Health, indicate that proteins from a plant-based diet are the healthiest in the long run.

In the book The China Study (2005) – one of America’s best-selling books about nutrition – the relationship between nutrition and chronic disease, including heart disease, diabetes, obesity and various forms of cancer, is examined. It is based on a twenty-year-study conducted by Oxford University and Cornell University in cooperation with the Chinese Academy

CHAPTER 6. The Natural Balance Soup

of Preventive Medicine, described by New York Times as: “the most comprehensive large study ever undertaken of the relationship between diet and the risk of developing disease”. Large populations in rural China were examined and compared to Western populations and the conclusion was that people with a high consumption of animal-based foods were more likely to develop a chronic disease, whereas people who ate the most plant-based food tended to stay healthier. These findings also comply with experiences from Okinawa.

The high protein content of the Natural Balance Soup is based on three plant-based protein sources: pea, soy and potato. When mixed together they provide all the amino acids that the body needs. The protein content was developed and tested at Igelosa in order to provide a complete vegetarian protein.

CHAPTER 6 The Natural Balance Soup

Natural Balance Soup ingredients include: pea protein, soy protein and potato protein.


Natural Balance Soups

FPOwill add hi-res image later


CHAPTER 7. “Mother’s meatballs” CHAPTER 7. “Mother’s meatballs”

CHAPTER 5. Introducing the Natural Balance Soup CHAPTER 5. Introducing the Natural Balance Soup

Elsa, 83 years old: The life saving role of nutrition in disease

Alexander, 76 years: The need for drinkable nutrition

Elsa was brought to the hospital when I was on call. I could immediately see that she was dying. The medical exam showed that she had an acute heart failure due to a stenotic heart valve. She was rushed to the surgery room, where an artificial valve was inserted without complications. However, Elsa was too weak to breathe on her own. After the operation she had to be connected to a ventilator.

After one week she had not regained her strength. Despite adequate parenteral nutrition, Elsa was still dependent on the ventilator after four weeks. She was so weak that she could barely raise her hand. But one positive factor was that her heart had regained power and she had no signs of heart failure. We could communicate with her in a good way, she was not depressed.

It is well known that the need for protein is increased after major surgery. I ordered an extra dietary supplement of protein-powder, given in a nasogastric tube for 24-hours a day. The physiotherapist was instructed to train all the muscles the patient could mobilize, which at that point were limited to some faint movements in her arms and feet. I also gave her an injection of a medicine that stimulates the protein synthesis.

Already after three days we could take her off the ventilator. And after two weeks Elsa was moved to rehab in good shape, all things considered. After a few weeks she had fully recovered and returned to a normal life in her home.

Alexander had smoked all his life. When I first met him, he had developed diabetes since a few years. He had never exercised and was now confined to a wheelchair. The medical tests showed aortic valve stenosis, meaning that the opening of the heart valve, which carries the entire output of the blood, was narrowed. Furthermore, he had coronary artery disease, with stenosis on all main branches of his coronary arteries. Alexander underwent surgery and received an artificial heart valve and five bypass grafts to the coronary arteries. He recovered surprisingly well from this major operation and was discharged from the hospital after three weeks.

Four months later his son contacted me to inform that Alexander’s condition had suddenly worsened. He was spending most of the time in bed, seemingly indifferent to everything. He had also lost his appetite. Medical examination revealed a fungal infection in the mouth and a badly fitted denture, which was therefore not used. Alexander was slightly dehydrated but his blood circulation and blood pressure were normal, indicating good heart function.

Complete liquid nutrition was prescribed and an experienced physiotherapist was assigned to him. Alexander was to follow a strict exercise program which included outdoor walks two times a day as well as weight training twice a week. His family also received instructions how to train him and they were told to monitor his progress closely. They were asked to be especially vigilant about Alexander’s food intake which consisted of liquid protein enriched nutrition, due to his poor dental health.

Alexander soon regained his vitality and humour. When I met him, twelve years later, he was still very active and often made travels in both Sweden and Denmark. He especially enjoyed spending time with his grandchildren and their friends. And he had even stopped smoking.


MEATBALLS”“Mother’s


Food is a sensitive subject. Cookbooks are extremely popular nowadays and in Sweden, apparently, one new cookbook is published every day. Mealtimes define families, friends and entire communities. Sharing food typically marks all the important events and celebrations in life. There are as many opinions and strongly held convictions about food as there are people in the world. When discussing a patient’s dietary habits (and body weight), the subject needs to be raised with the utmost sensibility. Otherwise the trust between patient and physician might be jeopardized. I usually start by asking if the patient’s mother is still alive. What does she eat? What did you eat when you were growing up? Breast milk? But then what?

“Mother’s meatballs” is a metaphor for what is dearest to a vulnerable patient, namely his or her mother. Most of us start out in life by receiving all our sustenance from our mother’s breast. This creates a very strong bond between mother and child. In Latin, the official language for anatomy, the name for the female breast is “mamma”. Never criticise the mother’s food habits (i.e. the patient’s food habits)! Many patients love a particular food dish and would never even consider refraining from it, however harmful it might be from a medical point of view. A physician who seeks to improve a patient’s food habits is therefore well advised to consider the biological law of dose and response: eating something harmful in small amounts will have hardly noticeable effects in the body. Therefore, when it comes to foods, and with the notable exceptions of allergies and alcohol for an alcoholic, there is no reason to prescribe total abstinence from a person’s favourite meal.

Since the 1960’s the food industry has revolutionized our lives. Today we can buy ready-made foods of almost any kind. However, studies of the healthiest and longest-lived people in the world show that they eat natural foods that have not been industrially processed. The nutritional basis for these people are whole intact grains with long preparation time, often in the form of porridge, as well as beans and other legumes, vegetables, fruits, berries and fish. These ingredients are supplemented by meat and eggs depending on availability. One such evidence-based nutritional philosophy is the Okinawa Program.

CHAPTER 7 “Mother’s meatballs”


OKINAWAThe

program


Okinawa is an island in the southern part of Japan. Like Sweden, Japan has a well-functioning civil registry. Population statistics are thus reliable. Japan has the highest life expectancy in the world and among the Japanese, the Okinawans live the longest. Since the mid-1970s the food habits, exercise and lifestyle practices of 600 inhabitants who have passed the age of hundred years have been the object of study between Harvard University and Ruykus University in Okinawa. In 2001 the result was published in the book The Okinawa Program, in which the authors describe the food habits and lifestyle of Okinawa’s native population.

The Okinawans stay lean by eating a low-calorie diet, based on slowly absorbed unrefined carbohydrates, practicing “hara hachi bu” (only eating until they are 80 % full). Their local food sources originate directly from nature and are prepared with as little intervention as possible. It is important to point out that the Okinawans do not eat a constructed or scientifically based diet, but what is available directly from nature. Their lifestyle is characterized by low stress, high quality social networks, keeping active the natural way and by their food habits, which can be summarized in eight main principles:

1 Eat eight vegetables and two fruits daily. This corresponds to 500-1000 g of vegetables a day. The relationship between vegetables and fruits are 4:1.

2 Eat whole grains at most meals. Whole grains are the main calorie rich type of food used. Depending on the amount of physical activity, the Okinawans eat in average 7-13 servings of whole grain foods daily. Whole intact grains need to be cooked for at least 30-40 minutes. The key words here are whole and intact. Rice is the most available staple in Okinawa and one serving is defined as ½ cup (100 ml) of cooked rice.

3 Eat three calcium foods daily. A sufficient daily intake of calcium is considered important. Cow milk and milk derivatives which ensure adequate calcium intake in Western culture are not part of the Okinawa diet. Instead,

CHAPTER 8 The Okinawa Programthe native population relies on green leafy vegetables in abundance and soya-based products to ensure calcium intake. Nowadays, it is common that soya milk and other soya products are supplemented with calcium.

4 Eat three servings of flavonoid foods daily. In comparison with Europeans, Japanese people in general and Okinawans in particular have high levels of flavonoid in their blood. Flavonoids are potent antioxidants. Legumes (beans, especially soya beans and peas), flaxseed, onion, broccoli and tea are rich in flavonoid. Thirty grams of cooked soya beans or one tablespoon of ground flaxseed correspond to one serving of flavonoid.

5 Eat two servings of Omega-3 foods daily. Fish rich in natural fat is the best source of the long Omega 3 fatty acids EPA and DHA. Ninety grams of cooked fat fish is considered as one serving. Two tablespoons walnuts, one tablespoon ground flaxseed, one teaspoon fish oil or one omega-3 egg are alternatives.

6 Drink fresh water and tea daily. One cup of tea contains 12-16 mg flavonoid and is considered as an important part of the Okinawa diet.

7 Weigh your options carefully. The food habits on Okinawa allow all types of foods as long as the intake of animal-based foods and sugar products are kept moderate to low. The intake of sweets is preferably in the form of raw fruits or berries.

8 Drink alcohol in moderation or not at all.

CHAPTER 8. The Okinawa Program


OKINAWAat Igelosa


The last twenty years I have been involved in scientific cooperation with several Chinese university hospitals. As a result of this I receive Chinese scholarship doctors who come and stay at Igelosa for a year and participate in my research. It was through these young Chinese doctors that I originally became interested in the Okinawa program. When the first students came to Sweden and were exposed to our national diet – rich in milk, cheese, meat, sausages, pizza and pasta – many of them gained 10-15 kg in the first three months. Although they loved the food they did not appreciate the weight gain, especially since these extra kilos proved difficult to get rid of again. I then decided to introduce the Okinawa program as an alternative at Igelosa. Not only did the young and overweight Chinese doctors now start to lose weight, but they also liked the food and were rarely – if ever – hungry. The problem with this food for Swedes was all the unfamiliar tastes. I hired professional chefs who were instructed to modify the taste and appearance of the Okinawa dishes to better suit our culture. The challenge was to make the Okinawa food philosophy appetizing for Westerners.

When the American chef Matthew Pohl came to stay at Igelosa in order to lose weight, it was natural that he also began eating according to the Okinawa principles. Matthew was told to document everything he ate and to carefully study the literature about the Okinawa program. As a trained chef, with a university degree in journalism, he was well qualified for the task. The story of Matthew’s remarkable weight loss will be highlighted in detail when we address the subject of obesity in later chapters.

Can we ever agree about what types of food are best? I doubt it. On the other hand, we do know what substances must be in the food to provide complete and calorie restricted nutrition. Because our patients and guest researchers come from around the world, the chefs at Igelosa need to follow the ideas of both Eastern and Western food traditions. However, food is ultimately a very personal thing and will always be based on each individual’s taste, tolerance and on the memory of “mother’s meatballs”.

CHAPTER 9. Okinawa at IgelosaCHAPTER 9 Okinawa at Igelosa


PHYSIOLOGYFood and


One of our visiting Chinese doctors had to be taken off duty from all afternoon operations due to extreme tiredness after lunch. In Sweden, lunch typically consists of a limited amount of (expensive) proteins and lots of (cheap) carbohydrates – usually potatoes, pasta and bread. What was the reason for his reaction? And why is it so common with afternoon tiredness? We decided to look for answers by studying the medical effects of ordinary food intake.

Our nation’s most popular meal is meatballs with mashed potatoes and lingon berries. We use this as our standard reference meal when conducting food studies at Igelosa. Figure 10.1 shows the blood sugar and insulin reaction of a healthy man (27 years old, 179 cm tall and weighing 65 kg) after intake of the reference meal. As can be seen in the figure, the blood sugar is immediately raised, causing a substantial amount of insulin to be released, which presses down the blood sugar again. While the blood sugar level is low, the person feels very tired (he reports 7 in a 10-point scale). Low blood sugar levels also trigger sugar cravings. Then we do not crave meat, fish or vegetables, but fast carbohydrates such as sweets, cookies and sodas that will cause even more insulin to be released. If the insulin level in the blood never decrease to normal levels, not even after a night’s sleep, then the metabolic syndrome has developed, which is a precursor to type-2 diabetes (90 % of all diabetes). The metabolic syndrome consists of high insulin, high blood pressure, overweight, bad blood lipids, and is a serious risk factor for disease.

When the same test-person is given a meal that has been properly balanced according to the Okinawa principles, the physiological response becomes completely different. As seen in figure 10.2 the blood sugar and insulin levels rose only moderately this time and the test-person did not report any significant hunger or tiredness during the four-hour trial period.

CHAPTER 10. Food and physiologyCHAPTER 10 Food and physiology

The standard reference meal consists of 127 g Swedish meatballs, 182 g mashed potatoes (39 g powder in 175 g water), freshly grated carrot and 35 g lingon berry jam. It contains: 21 g protein, 50 g carbohydrates, 22 g fat, 2 g fibre, in total 482 kcal

This meal consists of 100 g of oven-baked salmon, 100 ml whole and intact rice grains, 150 g ratatouille and 35 g salsa (tomato and capers). It contains: 24 g protein, 38 g carbohydrates, 14 g fat, 5 g fibre, in total 372 kcal

Fig 10.1 Fig 10.2


ANDOverweight

obesity


According to a 2008 WHO report, as many as 1.5 billion people above twenty years of age are overweight worldwide (BMI ≥ 25)*. Of them an estimated 200 million men and 300 million women are obese (BMI ≥ 30). Overweight and obesity are the fifth leading risk for global deaths. The problem has assumed epidemic proportions in almost all regions of the world and is serious among both adults and children.

There are many theories about the causes of becoming overweight. Too much calorie intake and too little exercise are obvious physiological causes. But are there also deeper, more causal explanations? One such hypothesis suggests that weight gain is ultimately caused by eating disorders, which in turn are symptoms of emotional instability. One study looking at what caused people in the West to seek a doctor identified the following three top reasons: chronic fatigue, stress and being overweight. All major studies on overweight and obesity indicate that it is very difficult to lose it permanently. Dietary counselling and exercise alone are often not enough. Fortunately, there are individual examples of people who have succeeded in significant permanent weight loss by changing their lifestyle. They provide inspiration and hope for the development of better strategies and treatments in the future. The American chef Matthew Pohl is one such example well worth highlighting.

CHAPTER 11. Overweight and obesityCHAPTER 11 Overweight and obesity

* Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person’s weight in kilograms divided by the square of his height in meters (kg/m2).


REVOLUTIONPhysiological


One of my close friends in the USA is the transplant coordinator Mary Pohl. We both agreed that it would be good for her son Matthew, or Matt, to come to Igelosa and become part of the community here for a period of time. When Matt first came he was 27 years old and weighed more than 150 kg. Here is his story in his own words.

CHAPTER 12. A physiological revolution

My name is Matthew Stewart Pohl. I grew up in a typical American suburban family. Although both my parents worked, my father as a minister and my mother as a nurse, they always made sure that my two older brothers and I got the attention and care we needed. As a child I was not extremely overweight, but I have been described as a “thick” child. In contrast, my brothers were always skinny and athletic. While I continued to gain weight, they were able to maintain their health, both eventually becoming pilots in the US military.

It did not take long before I began to notice that I was heavier than the other kids. My mother, who also dealt with weight issues as a child, did not want me to go through the same experiences she did. So she enrolled me in Weight Watchers when I was eight years old. They had never admitted such a young member to the program and were not sure how to deal with me. As I felt very uncomfortable there, the experience ended quickly. By my first year at high school, I weighed about 105 kg. When I graduated four years later, I had gained another 25 kilos.

When I was in high school, I played American football and worked out often. Once I started university, I stopped exercising but did not change my eating habits. If anything, they got worse. Beer and pizza became my principal sources of nutrition and by the time I graduated in 2002, I weighed around 140 kg.

After college I started working as a chef. In the mornings I would skip breakfast, and if I had anything, it was a few glasses of juice. At work I wouldn’t make time to sit down and eat proper meals, but instead snacked constantly and drank soda after soda. When I finished work late at night, I was always hungry and had a large meal after midnight. My diet at home was not much better than it was at work. After long days in the kitchen, I rarely wanted to take the time to cook for myself. The meals I ate were usually those I could prepare in a few minutes. I would also get fast food or carry-outs. It might sound strange but I thought that what I ate didn’t relate to what happened to my body. I spent my free time on the couch watching television instead of exercising or going out with friends. At this point, I gave up personal responsibility for my weight and health.

CHAPTER 12 A physiological revolution

Matthew together with his parents, Jim and Mary Pohl, in USA 2005.


I also had a hard time sleeping at night. It took me a long time to fall asleep, and I needed to switch on the television or radio to slumber. Once I was asleep I woke up frequently throughout the night from discomfort, mostly with cramps in my legs. I was also a heavy snorer, and from time to time would wake myself up.

Predictably, my relationships with others suffered as well. I had few friends, and because my self-esteem was low I didn’t make the effort of meeting new people. Whenever I would walk into a room I was immediately conscious of my weight and would recognise that I was the heaviest person there. I believed that my weight was the reason others did not like me. Now I realise that the real reason was me not liking myself.

I first came to Igelosa in February 2007. My mother was attending a lung transplantation course there and asked me if I wanted to join her. I saw the trip as an opportunity to visit Sweden. The health check my mother had arranged for me was low on my list of priorities. My biggest fear was that the doctors would tell me what I already knew, how bad my condition was. Midway through the week I had blood samples and measurements taken. All the levels, including insulin, CRP and cholesterol, were predictably high. But getting on the scale was the worst. I weighed so much that the scale, which registered up to 150 kg, could not display any higher. It was a real slap in the face but gave me, finally, the motivation I needed to start making changes.

Before flying home, I met Stig Steen to discuss what changes I needed to make. He told me to eat as much vegetables as I could, a kilogram a day if possible, and preferably raw. Also I should try to walk for at least 30 minutes every day. He gave me some literature suggestions and sent me home with samples of the Natural Balance Shake, which I should take in between meals every time I felt hungry.

Stig also invited me back to Igelosa as a long-term research patient. It didn’t take long for me to make up my mind, and as soon as I returned home, I gave my manager at work notice that I would be leaving my job. I was ready for a change.

My new life at Igelosa was framed by the following daily schedule:

6 AM Wake up7 AM Breakfast8 AM Walking with pedometer10 AM Snack 1: Natural Balance Shake and one fruitNoon Lunch2 PM Walking with pedometer4 PM Snack 2: Natural Balance Shake and one fruit7 PM Dinner9 PM Snack 3: Natural Balance Shake or 100 g raw vegetable11 PM Sleep

When I returned to Igelosa as a patient, I was instructed to focus all my time and energy on the changes I wanted to make. I was told to read The Okinawa Program, to cook my own food, to exercise, as well as to find time to relax and relieve the stress that had built up in my life. I was also instructed to keep a food journal and to record everything that I ate. This would help the doctors to analyse the caloric and nutritional content of my daily diet.




Food: Even though the ingredients varied from day to day, the compositions of the meals were much the same. I always started with a green salad with vegetables in different colours, dressed simply with a squeeze of citrus juice. The main dish consisted of 100 ml of cooked whole grains (1/2 cup), 100 g of a protein-rich ingredient (mainly fish, but also lean meat and egg) and a large portion of vegetables. At breakfast I added four fish oil pills (WellnessPack). Alcohol consumption was to be kept at minimal levels. Once a week I allowed myself a glass of red wine with the meal. Every time I felt hungry, I should take one Natural Balance Shake, but there was no upper limit for its use. And, very importantly: I was instructed never to skip a meal.

Exercise: I was directed to add low impact exercise to my daily life. I was given a pedometer to wear and goals were set for me based on the number of steps I took each day. At first, I was instructed to go out for a short walk every day. When that became easier, the goal became 10,000 steps each day. When this became routine, the goal was raised to 12,000 steps, and later on up to 15,000 steps every day. After six weeks I started using walking poles when I went out. This was

a great change. When I arrived at Igelosa I could hardly walk the flight of stairs up to my room on the second floor without catching my breath. Now I was walking around with walking poles and recorded some real progress.

Sleep: The changes in my food and exercise habits had a positive effect on my sleep. When I arrived I had trouble getting to and staying asleep. For the first month I needed to have the television on when I went to bed, and it was still difficult for me to get and stay comfortable throughout the night. As time went on, however, I started falling asleep without the television and was able to sleep better throughout the night. I stopped snoring and began to wake up before the alarm clock went off, refreshed and alert.

Relationships: The people at Igelosa are a big part of my life as they have made up the support group around me. During the days, I got involved in conversations with staff and guests when time allowed. In the evenings, I would cook and eat with the staff living at the centre.

Walking every day became a natural part of Matt’s life at Igelosa. At Igelosa Matt lived together with scholarship students and guest researchers from different parts of the world.


“

Matt is making a Natural Balance Shake which he is consuming in between meals whenever he feels hunger.

Challenges: There were plenty of challenges along the way. Naturally, I missed my friends and family back home. However, the biggest challenge was sticking to the program when I didn’t see any results in my weight loss. During the first month of my stay, I only lost a few kilos. It was hard to deal with this as I had hoped and expected better results. At times I wondered if I was doing something wrong, but I was told to stay on course. Patience paid off. After two months, I had lost fifteen kilos.

Motivators: During the last four years, accomplishments have not only been measured by weight and blood tests, but by everyday experiences too, like clothes fitting better or being able to walk a little further. On the flight back to the USA, before Christmas 2007, all my efforts seemed worthwhile. For many years, I had been embarrassed to fly, because I was so big that I couldn’t use a standard airplane seat belt. Asking for a seat belt extension was humiliating, and made me feel different from everyone else. On this flight, however, the standard seat belt clicked in!

When I returned to Igelosa, in September 2008, I became both a patient and an employee. Besides work in the kitchen, I was told to continue focusing on lifestyle change, especially my food habits and exercise. Along with daily walks, I began to jog occasionally and added light weight training to my program. By the end of the second year I was down to 96 kg. After living one year at the centre, I moved out and got my own apartment in the city of Lund.

In 2010, when the doctors declared me healthy, my weight was now 85 kg. The most important lessons I have learned are these: to be patient, to rely on the support of others, to set reasonable goals, to exercise daily, not to skip meals, to eat before getting hungry and to get a good night’s sleep. These are the reasons why I today feel better and happier than I can remember ever having felt before.

Today I feel better and happier

than I can remember ever

having felt before”


Medical data over three years

Normal fasting value for insulin is 38 mU/L.

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When Matt first arrived at Igelosa he had high fasting values of insulin. This made it very difficult for him to lose weight, since a high concentration of insulin in the blood closes the fat cells, thus keeping the fat inside them. Since the fat is captured in the cells weight loss is very hard, even during exercise or on a low calorie diet.

Due to Matt’s faithfulness to the program, his insulin gradually started to fall and then he also started to lose weight. This can be seen in figure 12.1 which shows Matt’s weight and insulin values over the first three years. A normal fasting insulin value is less than 8 units, and as can be seen in the figure, Matt now has normal insulin levels.

What is the secret to the remarkable change that Matt has accomplished? First and foremost, he decided to take a time-out from his stressful life; he trusted the advice he was given regarding food and exercise; the community he became part of loved him and admired him greatly for his strong determination to make changes in his life; and he started every new day after a good night’s sleep.

Matt’s example shows that radical changes in physiological parameters are possible by lifestyle change. This is good news in a world where weight gain and “lifestyle diabetes” is spreading in epidemic proportions, not only in the West but also in emerging and developing countries. More good news: Matt’s dietary habits are less expensive than a regular diet – up to 70 % cheaper according to our chefs – because most natural ingredients come directly from the fields or the sea.

Normal fasting value for insulin is 3-8. 1. Home in US 4. Home in US2. Christmas in US 5. Christmas in US3. Vacances in Paris

CLINICAL CHEMISTRY

Fig 12.1

Fig 12.2

From a doctor’s perspective looking at the laboratory data (Figure 12.2), the following comments may be made:

1. C-reactive protein (CRP) has normalized from 6.97 to 0.60, which indicates that a chronic inflammatory process has been overcome.2. His blood lipids have normalized. 3. His carbohydrate metabolism, as measured by blood glucose, HbA1c and insulin has normalized.4. His liver enzymes have normalized.5. His testosterone value has normalized.

2007-03-01 2008-02-27 2009-03-27 2010-03-05 Month 0 12,1 25,2 36,7 CRP 6,97 2,56 0,57 0,60 Glucose 5,46 4,69 4,31 3,51 HbA1c 4,62 3,89 3,90 3,70 Insulin 27,6 15,0 7,8 2,6 Cholesterol 5,69 4,06 3,68 4,20 Triglyceride 1,60 0,79 0,70 0,70 HDL cholesterol 0,88 0,79 0,88 1,13 LDL cholesterol 4,27 2,84 2,57 2,55 LDL/HDL quotient 4,85 3,59 2,92 2,26 P-Apo A1 1,17 1,00 1,05 1,24 P-Apo B 1,20 0,77 0,70 0,83 Apo B/Apo A quotient 1,03 0,77 0,67 0,67 Lipoprotein(a) 64,4 109,9 93,6 64,5 Cobalamin (vitamin B12) 387 333 189 230 Folic acid 13,5 16,8 28,7 31,8 Creatine kinase 4,57 2,10 2,03 1,73 Lactate dehydrogenase 4,02 2,45 2,63 2,66 Bilirubin,tot 10,0 8,7 7,8 7,7 Bilirubin, direct 2,55 2,23 2,41 2,36 Alcaline phosphatase 1,63 1,47 1,20 0,97 Glutamyltransferase 1,71 0,40 0,34 0,36 Aspartate aminotransferase 0,55 0,31 0,38 0,32 Alanine aminotransferase 0,98 0,55 0,63 0,41 Albumin 44,3 51,5 46,1 42,5 Pancreatic amylase 0,32 0,35 0,46 0,54 Creatinine 61,9 62,5 69,7 66,5 Urea 3,53 4,71 4,29 4,71 Uric acid 548 434 384 434 Thyroid-stimulating hormone 2,30 1,86 1,68 1,52 Thyroxine 17,7 16,4 17,6 17,8 Triiodothyronine 6,96 4,53 4,60 5,06 Cortisol 574 433 657 642 Testosterone 11,4 19,1 22,0 26,0 Dehydroepiandrosterone 8,49 8,09 7,45 9,56 Prostate-specific antigen (PSA) 0,260 0,283 0,318 0,387 PSA, free 0,080 0,122 0,147 0,210 PSA, quotient 31,8 43,1 46,2 54,5 Hemoglobin 161 145 147 146 Thrombocytes 224 184 178 236 Leukocytes 8,2 6,3 5,5 7,5

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KITCHENIgelosa

insights


Working in the Igelosa kitchen is not much like working in a typical restaurant. Here we have to rely as much on scientific literature as on cookbooks. At times we have more contact with physicians and PhDs than with our local food suppliers. The dishes often make their ways down the corridor to the medical clinic for further tests and analysis after intake. The medical accuracy makes it impossible to cheat with ingredients of any kind. In this chapter you will learn how to prepare some of the healthy dishes that are being prepared and served at Igelosa on a daily basis. As a supporting member of Igelosa Life Science Community you can find many more recipes on our homepage:

www.igelosa.com

Matthew Pohl, chef

Breakfast 1• 1 slice (20 g) Bread• 1 slice (25 g) Smoked salmon• 150 g Raw vegetables• 1 dl Yogurt, no sugar added• 25 g berries

Breakfast 2• 1 slice (20 g) Bread• 1 slice (10 g) Turkey • 1 slice (10 g) Low fat Cheese • 150 g Raw vegetables• 1 dl Yogurt, no sugar added• 25 g Berries• ½ Boiled egg

Breakfast 3• 150 g Raw vegetables• 1 dl Cooked oats• 25 g Berries• 1 Boiled egg

Breakfast AlternativesCHAPTER 13 Igelosa kitchen insights


1. Preheat oven to 200 degrees Celcius.

2. While oven is heating, combine first 8 ingredients and place in the fridge to allow flavors to combine while the fish cooks.

3. Place salmon fillets on a baking sheet and bake in the oven until lightly browned and cooked through, about 8-10 minutes.

4. Top with chilled tomato and caper sauce and serve with cooked whole grains and vegetables.

Baked Salmon withTomato-caper sauce

serves 4

1 Tomato, diced½ dl Leeks, chopped and washed2 tablespoons Capers1 teaspoon Lemon juice1 clove Garlic, chopped2 tablespoons Parsley, chopped½ teaspoon Salt½ teaspoon Pepper 4 Salmon fillets, 100 g each

h Lunch/Dinner

Lunch & Dinner Alternatives


1. Heat oil in a soup pot and add onion, carrot, celery, bell pepper and garlic and cook until softened, about 10 minutes.

2. Add water, salt, pepper and beans and simmer for twenty minutes.

3. Add fresh herbs and vinegar and serve.

serves 4

2 teaspoons Rapeseed oil2 medium Yellow Onions, chopped2 medium Carrots, peeled and chopped3 stalks Celery, chopped1 Red Bell Pepper, chopped2 cloves Garlic, chopped1 liter water2 cans White beans, drained and rinsed1 teaspoon Salt½ teaspoon Black Pepper1 tablespoon Fresh thyme, chopped2 tablespoons Parsley, chopped1 tablespoon Red Wine Vinegar

h Lunch/Dinner

White Bean and Vegetable Soup


1. Heat 1 teaspoon of oil in a large pan over medium high heat and add cabbage and cook until it begins to soften, about 10 minutes.

2. Add the honey, water and half a teaspoon of salt and cook until tender and browned.

3. Heat remaining oil in a small pan and cook onion until golden, about 6-8 minutes. Combine onion with the chicken, cooked dinkel, salt, black pepper, egg and water and stir to combine.

4. Arrange half of the browned cabbage in the bottom of a baking pan and arrange chicken mixture over the top of it, followed by a layer of the remaining browned cabbage.

5. Bake in 175 degree Celcius oven for about 45 minutes, or until the chicken is cooked through.

serves 4

1 kg White cabbage, thinly sliced1 teaspoon Honey1 dl Water½ teaspoon Salt300 g Chicken breast farce½ Yellow onion, cut into 1 cm pieces1 ½ dl Cooked dinkel1 teaspoon Salt½ teaspoon Black pepper2 teaspoon Rapeseed oil, divided1 Egg1 dl Water

h Lunch/Dinner

CabbagePudding


Snack 1• 1 medium apple• 25 g Walnuts

Snack 2• 100 g Low fat cottage cheese• 25 g Berries

Snack 3• 150 g Raw vegetables

1. In the bowl of an electric mixer whip eggs until light and fluffy and tripled involume.

2. Add Natural Balance Shake powder, yogurt, lemon juice and zest and mixuntil just combined.

3. Pour into an oiled spring form pan and bake in 180 degree Celcius oven for 50-60minutes, or until a knife can be cleanly removed.

10-12 slices

4 Eggs1 dl Vanilla Natural Balance Shake Powder4 dl Natural, strained yoghurt (10% fat)2 tablespoon Lemon juice, from 1 lemon plus zest

The Queen’s Cake

h Healthy dessert once in a while...

This lemon and vanilla flavoured yoghurt cake was prepared for dessert when H.M. Queen Silvia of Sweden visited Igelosa. On that day, by coincidence, a group of visiting doctors from Oslo and Paris were also at Igelosa and shortly after the Queen had left they all requested the same dessert, asking for the Queen’s cake.

Snack Alternatives


ON LOVEand life


Attending the first lecture at a medical university, the anticipant students were welcomed by an old professor. He began by asking them a question: “Can anyone tell me when the night turns into day?”

The room became completely silent for a long time, until a male student spoke out: “When I am sitting at my watch post in the forest, and I can see the difference between a dog and a fox from a hundred yards away, then the morning has arrived.”

The old professor remained silent, calmly waiting for more suggestions. After a short while, a female student raised her hand: “Professor, when I can distinguish a lily from a rose from ten yards away, then the morning has come.”

Still, the old man kept his silence. A nervous atmosphere spread among the students, until one of them impatiently cried through the murmur: “You tell us, then!”

Finally, the professor started to speak, and now all the students listened in complete silence: “When you can look every single person you meet in the face, and therein see a sister or a brother, then the night has turned into day in your lives”.

(Based on the writings of Martin Buber, freely told from my memory)

In Greek there are three words for life: bios, psyche and zoe. Biological life (bios) develops in childhood and reaches its full potential in adult life before it begins to decline. We can compensate for this unrelenting decline by making wise priorities concerning our health. Such priorities will also affect our psychological life (psyche) and keep it in a good condition. The longevity of successful authors, artists, scientists, politicians, entrepreneurs and many others can attest to this. Both the biological and the psychological life can be empirically measured in the individual person by different methods.

The third type of life, zoe, cannot be measured. This life is nonetheless equally real and can be perceived through its “symptoms”: mercy, joy, peace, patience, kindness, goodness, trustfulness, gentleness and self-control. It thrives whenever and wherever people love each other unconditionally. Furthermore, unconditional love may grow throughout life. Kinship, skin colour and status are not important. It is this life that severely ill patients long for more than anything else. The hopeful thing is that this life is not dependant on money: it can be given by anyone, always for free.

Each one of us is born with a unique set of genes: a potentiality of talents, ready to be actualized in life. Only you can develop your own special talents. The present moment is what you have at your disposal. Yesterday is no more and the future is not yet here. Good planning and wise priorities for your short-term and long-term future, based on your experience from the past, are of the utmost importance for how your life will be. There is one common purpose for us all: the greatest thing in the world: Love. No man can live without love. The golden rule teaches us to treat every person we meet as we ourselves would like to be treated. Let the golden rule permeate the present moment and happiness will characterize your life, whatever talents you will live out.

CHAPTER 14 On love and life CHAPTER 14. On love and life


Literature List:Colin Campbell, Thomas Campbell II, The China Study, Benbella Books, Dallas, 2006

Kenneth H. Cooper, MD, Dr. Kenneth H. Cooper’s Antioxidant Revolution, Thomas Nelson Publishers, Nashville, 1994

Fontana L. The scientific basis of caloric restriction leading to longer life, Curr Opin Gastroenterol, 2009 Mar; 25(2):144-50

William F Ganong, Review of Medical Physiology, Twenty-first edition, Lange Medical Books/McGraw-Hill, New York, 2003

Viktor Frankl, Man’s Search for Meaning, Washington Square Press, Simon and Schuster Inc,New York, 1997

Jane Higdon, An evidence-based approach to vitamins and minerals, Health benefits and intake recommendations, Thieme, New York, 2003

Jennie Brand-Miller, Thomas M S Wolever, Stephen Colagiuri, Kaye Foster-Powell, Johanna Burani, The Glucose Revolution, The authoritative guide to the glycemic index, The groundbreaking medical discovery, Marlowe & Company, New York, 1999

Dean Ornish, Love & Survival, HarperCollins Publishers, Inc. New York, 1998

Linus Pauling, How to Live Longer and Feel Better, First published in 1986 by W H Freeman and Company, Oregon State University Press, Corvallis OR, 2006

Norman Vincent Peale, Six Attitudes for Winners, Tyndale House Publishers Inc. Illinois, 1989

Anthony Robbins, Notes from a Friend, A quick and simple guide for taking charge of your life, Simon and Schuster Inc, Sydney, 1997

Gary Small, MD, The Longevity Bible, 8 essential strategies for keeping your mind sharp and your body young, Hyperion, New York, 2006

Robert Spitzer, PhD, Healing the Culture, A Commonsense Philosophy of Happiness, Freedom and the Life Issues, Ignatius Press, San Fransisco, 2000

Bradley J Willcox, D Craig Willcox, Makoto Suzuki, Based on the Landmark 25-year study, The Okinawa Program, How the world´s longest-lived people achieve everlasting health – and how you can too, Three Rivers Press, New York, 2001

Walter C Willet, Eat, Drink, and Be Healthy, The Harvard Medical School Guide to Healthy Eating, A Harvard medical school book co-developed with the Harvard School of Public Health, Free Press, Simon & Schuster, Inc. New York, 2001

Igelosa - Oriflamemacedonia.oriflame.com/2013/C9/IgelosaBook.pdf · Igelosa Home of Wellness by...

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