Chiropractic Insights. Christopher Kent D.C., Esq.

      3.Sanchis-Gomar F, Garcia-Gimenez JL, Perez-Quilis C, et al. Physical exercise as an epigenetic modulator. Eustress, the "positive stress" as an effector of gene expression. J Strength Cond Res, 2012 May 3. (Epub ahead of print)

      4.Alegria-Torres JA, Baccarelli A, Bollati V. Epigenetics and lifestyle. Epigenomics, 2011 Jun;3(3):267-77.

      5.Martinez JA, Cordero P, Campion J, Milagro FI. Interplay of early-life nutritional programming on obesity, inflammation and epigenetic outcomes. Proc Nutr Soc, 2012 May;71(2):276-83.

      6.Lim U, Song MA. Dietary and lifestyle factors of DNA methylation. Methods Mol Biol, 2012;863:359-76.

      7.Saveanu RV, Nemeroff CB. Etiology of depression: genetic and environmental factors. Psychiatr Clin North Am, 2012 Mar;35(1):51-71.

      8.Hamilton JP. Epigenetics: principles and practice. Dig Dis, 2011;29(2):130-5.

      9.Ornish D. Changing Your Lifestyle Can Change Your Genes. Newsweek, June 16, 2008.

      10.Ornish D, Magbauna MJM, Weidner G, et al. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. PNAS, June 17, 2008;105(24):8369-8374.

      11.Watters E. DNA Is Not Destiny. Discover Magazine, November 2006.

      Chapter Six

      Changing the World: Our Leadership Opportunity

      Like many of my contemporaries, I chose chiropractic as a career because I wanted to make the world a better place. Helping people to achieve their potential as human beings was the vision. Today's crisis in health care speaks more eloquently than words of the timeliness of this opportunity.

      Medical physicians Wayne Jonas and David Rakel wrote, "Leadership is crucial. We need the innovators who will reach out and grab the concepts of health and caring that are now sitting out in the periphery and bring them into the mainstream ...We need the industry - producing the tools and technologies for a wellness system as powerful and as vast as the disease treatment system we currently have. Imagine a system that has expertise in the creation of health. What would it look like, and what kind of professionals would be needed for it to succeed?"¹

      Promoting the Right Lifestyle Choices

      I propose that the chiropractic profession is perfectly poised to provide this leadership. From its inception, the chiropractic profession has noted the significance of lifestyle choices. D.D. Palmer acknowledged the role of physical, chemical, and emotional stress in the dynamics of health and disease when he wrote, "[T]he determining cause of disease are traumatism, poison, and autosuggestion."² Chiropractors have acknowledged these factors as causes of vertebral subluxations, as well as contributors to disease in their own right. Consider the impact that lifestyle factors have on health care costs and health-related quality of life:

      

"Determinants of well-being transcend health care ... since health care contributes only about 10% toward reducing premature death ... Lifestyle choices, not medical and surgical treatments, are the determinants of longevity over which we have control."³

      

In a study of 84,941 nurses with 16-year follow-up, the authors concluded that a total of 91 percent of the cases of type 2 diabetes in this cohort could be attributed to habits and forms of behavior that did not conform to the low-risk pattern.⁴

      

Daily use of a multivitamin by older adults could lead to more than $1.6 billion in Medicare savings over the next five years.⁵

      

Health care costs could be cut by $24 billion if Americans took just four supplements over the next five years.⁶

      

Hyman, Ornish, and Roizen reported results of the EPIC study⁷ involving 23,000 subjects, which examined how adherence to four simple behaviors (diet, exercise, BMI less than or equal to 30, and not smoking) affected health. "In those adhering to these behaviors, 93% of diabetes, 81% of heart attacks, 50% of strokes, and 36% of all cancers were prevented."⁸

      

Chiropractic patients ages 65 and older who were under chiropractic care for five or more years experienced 50 percent fewer medical provider visits than their comparable peers and spent only 31 percent of the national average for health care services. The health habits of patients receiving maintenance care were better overall than the general population, including decreased use of cigarettes and decreased use of nonprescription drugs.⁹

      

In an independent practice association (IPA) that permitted patients to select a doctor of chiropractic as their primary care physician, clinical and cost utilization based on 70,274 member-months over a seven-year period demonstrated decreases of 60.2 percent in hospital admissions, 59 percent hospital days, 62 percent outpatient surgeries and procedures. There was an astounding 85 percent decrease in pharmaceutical costs when compared with conventional medicine.¹⁰

      Epigenetics--Changing Gene Expression

      Exciting as the above findings are, they take on a new level of significance when considered in the context of epigenetics. As cell biologist Bruce Lipton explained, "It is now recognized that the environment, and more specifically, our perception (interpretation) of the environment, directly controls the activity of our genes. Environment controls gene activity through a process known as epigenetic control."¹¹

      Simply stated, we are not slaves to our DNA. Our interpretation of the environment determines how genes express themselves, and we can direct our interpretation of life's events. We are not bound by biochemical caprice. As sentient beings, we sculpt our biology.

      According to a recent issue of Time magazine, "Factors like diet, stress and prenatal nutrition can make an imprint on genes that is passed from one generation to the next."¹² The article noted that lifestyle factors in parents could profoundly affect the longevity of their children. In a seminal study, Dean Ornish and colleagues found that comprehensive lifestyle changes altered gene expression in patients with prostate cancer.¹³ The study found that more than 500 genes changed their expression. Newsweek reported that "New research shows that improved diet, meditation and other non-medical interventions can actually 'turn off' the disease-promoting process in men with prostate cancer."¹⁴

      The message for the chiropractor is stunning: Lifestyle choices may result in changes in gene expression that are passed to future generations. As stated by Walters in Discover magazine, "Epigenetics is proving we have some responsibility for the integrity of our genome ... Before, genes predetermined outcomes. Now everything we do ... can affect our gene expression and that of future generations. Epigenetics introduces the concept of free will into our idea of genetics."¹⁵

      Hyman, Ornish, and Roizen observed, "Personalized lifestyle medicine is a high-science, high-touch, low-tech, low-cost treatment that is more effective for the top 5 chronic diseases than our current approaches. Yet is it not taught in medical schools, practiced by physicians, or delivered in hospitals or healthcare settings ... If lifestyle medicine becomes central to the practice of medicine, our sick care system will be transformed into a healthcare system."⁸

      As a chiropractor, you are a facilitator in determining humanity's legacy. The decisions you make, and the actions you take today, sculpt your future and that of