The Impact of Vitamins and Supplements Presented by Georgia Tetlow, MD March 13, 2013.

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


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



• 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


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



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



“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



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.



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



Your Plate



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



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



Why Supplements, Anyway?

– Strengthen the immune system– Reduce inflammation– Reduce free radicals– Reduce DNA damage that leads to cancer



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



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



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



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



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



• 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…


Vitamin D3 continued…



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



Fish Oil Slows Tumor GrowthHardman, J. Nutr. 132:3508S-3512S, 2002



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



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



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



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



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



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



Breast cancer prevention: 1 drink daily or less



Mind-Body Interventions -Mindfulness



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.



“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



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



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



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

http://vimeo.com/28516754

Upcoming Webinar

Detoxify Mind & Body – Today!• Friday, April 5, 2013 (12-1pm)

– Detoxify your mind• Focus on your purpose• Address emotional blocks that undermine energy and reduce

hope– Detoxify your body

• Learn how the elimination diet profoundly detoxifies and potentially addresses hardest-to-treat symptoms

• Webinars: less than $20



Thank you!

www.philly-im.com888-702-7974

[email protected]


The Impact of Vitamins and Supplements Presented by Georgia Tetlow, MD March 13, 2013.

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Transcript of The Impact of Vitamins and Supplements Presented by Georgia Tetlow, MD March 13, 2013.