WARNING: Clinical dispensing of these agents causes positive side-effects

In the days leading up to the January 13, 2011 closing of the comment period on the draft National Prevention (and Health Promotion) Strategy, an integrative medical doctor engaged me in an e-dialogue that went something like this:

Me:  The point the integrative practice community needs to make is that whole person approaches are by nature primary preventive and health promoting. They bridge the historic chasm between reactive, disease-focused clinical medicine and population-based prevention and health promotion strategies  

IM doctor: The problem is that we don't have much evidence that CAM is health promoting. 

Cherkin: "positive outcomes not captured"

1. Cherkin & Sherman at Group Health Research Institute: "Unanticipated benefits ..."

"Our analysis identified a range of positive outcomes that participants in CAM trials considered important but were not captured by standard quantitative outcome measures. Positive outcome themes included increased options and hope, increased ability to relax, positive changes in emotional states, increased body awareness, changes in thinking that increased the ability to cope with back pain, increased sense of well-being, improvement in physical conditions unrelated to back pain, increased energy, increased patient activation, and dramatic improvements in health or well-being. The first five of these themes were mentioned for all of the CAM treatments, while others tended to be more treatment specific.

Ornish: Not merely reversing atherosclerosis

2.  Dean Ornish in the New York Times: " ... the only side-effects are good ones"

"These include reversing heart disease and Type 2 diabetes, reductions in LDL cholesterol comparable to what can be achieved with statins, and improvements in gene expression like turning off genes that promote inflammation, prostate cancer and breast cancer."

Seely: many positive secondary outcomes

3. Seely & Herman with Canada Post: " ... secondary outcomes"

In August 2010, Canadian College of Naturopathic Medicine research director Dugald Seely, ND and health services researcher Patricia Herman, MS, ND, PhD reported preliminary outcomes of a multi-factorial, nutritional and mind-body, integrative intervention for employees of Canada Post, the Canadian postal service. The team examined the potential of an individualized whole person naturopathic intervention in reducing cardiovascular risk. The principal findings were of reduced risk and $1025 per employee in projected cost savings.

In addition, these naturopathic physician researchers chose to examine the kinds of outcomes Cherkin and Sherman recommend. The "secondary outcomes" garnered through patient self-report via MYMOP included positive changes in numerous areas related to:

" ... fatigue, sleep, weight, stress, allergic symptoms, hypertension, coffee consumption, musculoskeletal problems, etc."

" ... strategic planning process forged a realization that although half of CAM use by Americans is aimed at improving general health, most CAM research to date has focused on the application of CAM practices to the treatment of various diseases and conditions."

Gaby: "side-effects are positive ..."

We do not need to continue this chasm between reactive, disease-focused clinical practices and pro-active health promotion and primary prevention interventions. I offered the evidence of these 3 studies to Surgeon General Regina Benjamin, MD, MBA on January 13, 2011, the last day they accepted public comments. I might have added comments from nutritional medicine maven Alan Gaby's MD in his 1374 page textbook, Nutritional Medicine:

"Many of the 'side-effects' reported by patients who follow a nutritional program are positive, such as more energy, better mood, fewer cravings, better mental concentration and less aches and pains."