Save your brain with the Mediterranean diet?

According to Gad A. Marshall, MD (Instructor in Neurology, Harvard Medical School, and Associate Neurologist, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston) two recent studies demonstrate a reduction in the risk of mental decline in people who follow a Mediterranean diet. In a study in New York City, risk this showed up as a decline in the risk of Alzheimer's dementia in those who followed a Mediterranean diet, exercised regularly, or both. The hazard ratios were 0.6, 0.67, and 0.64 respectively. The study was large, well controlled of confounding factors and followed people for over 5 years. It would appear that in this population the diet reduced the risk of dementia by about 30-40%! A similar study in France, which was smaller, showed reduced cognitive decline (better maintained brain function) but not reduced risk of dementia. This study may not have been powerful enough to show benefit in preventing Alzheimer's, but results are still encouraging.

It seems to me the more we learn about diet and exercise, the more benefits we find. Perhaps Hippocrates was on to something when he recommended healthy (presumably Mediterranean given his location) diet, fresh air and exercise!

An example of good parenting!

I was sitting on our front porch this evening because it was warm and beautiful. Lots of people were walking by, walking dogs, riding bikes etc. A mother with a boy about 4-5 years old passed. He was riding a bike which hit a bump and he went sprawling hands first onto the sidewalk. It almost looked like he leaped forward. He rolled over onto his butt and was clearly unhurt. He looked up at "Mom" for a reaction. I would expect to see her concern, maybe some sympathy, even offering a cookie or treat. Many times I've seen the "Oh, oh are you OK" response which usually just make the child cry. This Mom remained smiling. Her response was "So, did you catch the rabbit?" How inspired! He did look a lot like my beagle when she tries to jump something, only difference is no howl from the kid! I couldn't tell the mother what a good job she did, and I doubt she will ever read this, but at least I can tell someone. Hope it helps you keep your stumbles in perspective. May you "catch the rabbit!"

Wholistic, holistic or integrative?

There are a lot of terms around to describe the attempt to integrate body mind and spirit into health. Some of the more common terms are integrative, functional, mind-body, holistic and wholistic. None of these terms yet conveys anything very specific about the practitioner or style of practice. I'd say this is in development, but if so it has been for a long time! When I first became interested in "wholistic" medicine it was spelled with a "W" and done mostly in church basements. The "holistic" moniker has often been used by chiropractors and often includes nutrition, supplements and the like as well as manipulation. Integrative and functional are more recent terms used by a variety of practioner types, including a few of us bolder MD's. It implies bringing together multiple disciplines to improve health and/or treating function rather than disease.

As I reflect on my preferences, I find myself gravitating toward the older "Wholistic" for a few reasons. The concept of "whole" including multiple aspects of body, mind and spirit. I know the actual root of "holistic" is "hol," the same root as Holy. It seems to imply more focus on the spiritual. Although this emphasis is not a bad idea given the subordinate position the spirit is usually given, a more even emphasis is more to my liking. I think as a wholistic practitioner I should be willing to address body mind and spirit in any combination and not value one above another.

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What is a doctor?

The mind body expo this weekend in Minneapolis gave me a different perspective on my title. If I said I was a "doctor" or a "physician" I got constant requests for clarification! The only unambiguous title was "MD" but this was not always a welcome one. Considering insurance companies now insist on calling me a "provider" (which I always thought was something I helped do for my family, being one of only two) I'm beginning to wonder if society has a role for people like me. Surely the education, study and practice of the past 30 years are of value. I know my skills are helpful to people and believe in my own worth independent of titles, but they do help people understand roles. I am not really ready to given them up either to generalization from "physicians" who have had much less training, or to be downgraded by insurance to a generic cog in the wheel- the role is only to see patients and generate revenue.

This brings me to what I should call the people who come to me for care. For decades I have used the term "patient" (and many of them have been VERY PATIENT with me, especially in the early years!) but I am coming to prefer the more modern term of client. This puts us on more of an equal footing which I do like. We are really collaborators in health.

Once the relationship is established, I don't think it matters as much what we call each other, but names do have implications.