\r\n \r\n *Orthomolecular Medicine News Service, June 25, 2012*
\n
\nThe Forces Against Health in Australia Nutritional medicine could save
\nhundreds of millions of lives, but vested interests actively pursue the
\nopposite.
\n
\n(*Commentary by Ian Brighthope, M.D.*)
\n
\n(OMNS June 25, 2012) Health practice in Australia is still focused on
\ntreatment of disease as opposed to its prevention and the optimization of
\nhealth. Although the scientific literature has recently shown an increasing
\nawareness of the importance of lifestyle factors in preventing disease,
\nmainstream medical professionals continue to be trained to react to disease
\nand pursue drug treatment. This "drug and disease" paradigm is costly, not
\nonly in monetary terms but also the human toll of pain and suffering and
\nits impact on productivity and quality of life, and widespread illness and
\ndeath caused by medical treatment.
\n
\nIain Chalmers, director of the UK Cochrane Centre, has said that "Critics
\nof complementary medicine often seem to operate a double standard, being
\nfar more assiduous in their attempts to outlaw unevaluated complementary
\nmedical practices than unevaluated orthodox practices . . . These double
\nstandards might be acceptable if orthodox medicine was based solely on
\npractices which had been shown to do more good than harm and if the
\nmechanisms through which their beneficial elements acted were understood."
\nUnfortunately, neither of these conditions hold true.
\n
\nThe Australian government has made investent in the prevention of disease a
\npriority in its $7.4 billion comprehensive reform package to the nation\'s
\nhealth system. Yet prevention has been a secondary consideration in most
\nmedical schools and practices. A huge amount of disease and death could be
\nprevented by addressing the use of tobacco and alcohol [2]. There remains
\nan enormous void in the government\'s health policy because it does not
\nencourage and support the medical profession to practice nutritional
\nmedicine.
\n
\nChanging Attitudes
\n
\n"Individuals are ceasing to be mindless consumers of drugs and services,
\nbecoming more discriminating and aware in their choices. They are also
\nbringing their new options back home to their family physicians, and
\ncontributing to an awareness among doctors of the existence and potential
\nof natural therapies." [3]
\n
\nResearch in the field of nutritional medicine is growing at a phenomenal
\nrate, and now that the human genome has been sequenced, the science
\nsupporting nutrition in preventing disease is more impressive than ever.
\nMany general practitioners and academics are open to the use of diet and
\nnutritional supplements as viable alternatives to drugs. However, there are
\nstill too few to make a significant impact on public health. There will
\nalways be resistance, even hostility from the nutritional "flat-Earthers" -
\nthose who believe that "if you eat a balanced diet then you cannot be
\ndeficient in essential nutrients" (despite overwhelming evidence to the
\ncontrary) - and the academic medical power brokers. But I believe the
\nsystem will eventually change in line with the accumulating evidence.
\n
\nRecently, leading economic forecasters Access Economics announced that
\nexpanding the use of complementary/nutritional medicines could maintain
\nexcellent patient outcomes while saving hundreds of millions of dollars a
\nyear in healthcare costs. They studied the cost-effectiveness of common
\nnutritional treatments for common chronic and serious conditions. They
\nevaluated acupuncture for chronic lower back pain, St John\'s Wort for mild
\nto moderate depression, fish oils in the prevention of heart disease and
\nfor the treatment of rheumatoid arthritis.
\n
\nThe director of Access
\nEconomics, Lynne Pezzullo, said that analysing each treatment on a
\ncase-by-case basis showed patients could save a considerable amount of
\nmoney by using nutritional medicines. In the case of St John\'s Wort, for
\nthe 340,000 Australians who are being treated for mild to moderate
\ndepression with drugs that don\'t work well, she estimated a saving of $50
\nmillion per annum. The potential savings from the use of vitamins C, D, and
\nE and fish oils in heart disease is in excess of $2 billion.
\n
\nThe executive director of the National Institute of Complementary Medicine
\nwho initiated the study, Professor Alan Bensoussan, commented "I think
\ngovernments should ... look more closely at what implications this might
\nhave in the context of national health reform." [5] I agree wholeheartedly,
\nand have been pushing for similar reforms for many years. I hope this will
\nmark the beginning of a new endeavor to change our overburdened health care
\nsystem.
\n
\nPoliticians and regulators are very cautious about such change for
\nfear of reactions from the medical and pharmaceutical establishment, who
\nmay perceive competition for the health dollar as a threat. But there is
\nenough work to do in the goal of optimal health to keep every doctor,
\nhospital, naturopath, and nutritionist busy for decades. That is, unless a
\nmiracle occurs and megadose vitamin C and a few vitamins and minerals
\nbecome widely used. For these supplements can prevent widespread
\ndeficiencies that are responsible for many age-related diseases.
\n
\nThe "Wellness Model" of health attempts to prevent disease and optimise
\nhealth by encouraging people with the proper nutrition and lifestyle tools.
\nThis can achieve the maximum level of health, physical and mental, for each
\nindividual. It creates an optimal environment for the expression of that
\nindividual\'s genetic potential. The keys to achieving optimal health
\ninclude the judicious use of nutrition and nutritional supplements, regular
\nphysical exercise, the avoidance of environmental pollutants, and the
\npractice of positive outlook through simple techniques such as meditation.
\nThis concept of optimising health for everyone is foreign to most
\ntraditional doctors and is glaringly absent from medical school curricula
\nand training.
\n
\nLobbying for Disease
\n
\nIn this debate there are insidious influences. A powerful lobby group
\ncalled the Friends of Science in Medicine (FOSM) is actively discouraging
\nthe federal government from supporting universities with funding if they
\nconduct courses in what they personally regard as unscientific. Shamefully,
\nthe FOSM don\'t have members trained in NM and the nutritional sciences.
\nFOSM is predictably against nutritional supplements, regarding them as
\nexpensive and wasteful. Could the money spent on nutritional supplements be
\nbetter spent in more hospitals by treating the sick with drugs? In effect
\nFOSM insists that universities should only teach what it defines as
\n"correct" knowledge - emphasizing the treatment of disease, not the
\npromotion of health. FOSM and the medical establishment would do well to
\nbecome aware of the vast literature on nutritional medicine and the
\nclinical experience of scientifically trained nutrition-aware doctors and
\nnutritionists.
\n
\nNutritional Supplements in Medical and Pharmacy Practice
\n
\nMost drug prescriptions are unnecessary, an estimated 80% in Australia. [6]
\nThe list is long and includes antibiotics, statins, antidepressants, and
\nmany more. Yet through the best education, lifestyle, fitness, dietary
\nchange and the proper use of nutritional supplements and herbal medicines,
\npatient health outcomes can be optimised and hospital admissions and
\nadverse drug events significantly reduced. In 2009, government expenditure
\non the pharmaceutical benefits scheme (PBS) amounted to $6.9 billion
\nand it is estimated that in 2009-10 it grew a further 9.3%.
\n
\nI believe
\nthat at least $3 billion could be wiped off the total PBS expenditure and
\nthat these savings could be used to promote better nutrition, physical
\nfitness and safe, effective natural therapies. For example, use of more
\ncost-effective niacin or St. John\'s Wort as antidepressants could free up
\nmore money to psychiatrists for proper counseling and to orthomolecular
\nnutritionists for feeding the mind. Overall this would lead to greater
\nknowledge, more support for the most appropriate research, and an economic
\nbenefit to the world\'s population.
\n
\n*"There is an angry scornful tone used in leading textbooks of medicine
\nregarding the discussion of micronutrient supplementation; an arrogance and
\nignorance concerning the evidence for the possible benefit of
\nsupplementation."
\n
\nDoctors and pharmacists play a major role in informing consumers about the
\nsafety, efficacy and correct use of nutritional supplements. A recent
\nAustralian study evaluated the use of both nutritional and prescription
\nmedicines by pharmacy customers. 72% had used nutritional supplements
\nwithin the previous 12 months, 61% used prescription medicines daily, and
\n43% had used both.
\n
\nThe most popular nutritional supplements were:
\nmultivitamins, fish oil supplements, vitamin C, glucosamine, vitamin B
\ncomplex, probiotics, Echinacea, coenzyme Q10, Ginkgo biloba and St John\'s
\nWort. The authors of the study explained that customers or patients want
\nmore information, ask more questions, and no longer blindly accept the
\nauthority of health care providers. This new class of customer differs
\ndrastically from the gullible consumer of nutrition supplements often
\ncharacterized by the mainstream media. According to this study, nutritional
\nsupplements were selected by the majority of people themselves, although
\npharmacists and pharmacy assistants were helpful in this choice. From only
\na few bottles of vitamins in the 1980s to shelves of vitamins and essential
\nnutrients lining the pharmacy walls, there has been a massive change in the
\nretail pharmacy. The demands of an informed public plus the need for
\nprofits drove the pharmacy industry into selling nutritional supplements.
\n
\nThe study also highlighted that some customers currently feel pharmacists
\nare ill-equipped to counsel them about nutritional supplements. Many don\'t
\neven refer to pharmacists as an information source. Pharmacists also felt
\nill-informed about supplements, and experienced frustration when dealing
\nwith inquiries about nutritional medicines and natural health products.
\n
\n*"We must act on the facts and the most accurate interpretation of them,
\nusing the best scientific information. That does not mean that we must sit
\nback until we have 100% evidence about everything. When the state of the
\nhealth of the people is at stake, we should be prepared to take action to
\ndiminish these risks even when the scientific knowledge is not conclusive.*
\n
\nUnfit to Practice
\n
\nThere is not a single medical school in Australia teaching adequate
\nnutritional science to future doctors to ensure that they are fit to
\npractice in proper health care. This applies equally to general
\npractitioners and specialists. Most of any doctor\'s patients are going to
\ndie from a nutritionally based disease, yet for years before they die they
\nhave formidably obvious nutritional deficiencies that go undiagnosed.
\nFortunately in Australia, we have highly qualified nutrition-aware health
\nscientists in the profession of Natural Therapists who can help to correct
\nthese deficiencies.
\n
\nMedicine stands on two feet - the science and the clinical art. Take away
\neither one and it is going nowhere. Science on its own doesn\'t work because
\npeople aren\'t widgets; we all have different needs and different strengths,
\nbut medical research finds it easiest to treat us all the same. Got
\narthritis? Take this painkiller. But painkillers may destroy the joints,
\nand in the case of the most common, paracetamol, cause damage to multiple
\ninternal organs - while simple things such as changing the diet, movement,
\nvitamins, glucosamine and turmeric, among many others, have been shown to
\nbe very safe and effective.
\n
\nClinical skills also need to be advised by good science, the constant quest
\nfor understanding. In reality nutritional biochemistry holds the answers to
\nmost of our health problems, but movements such as FOSM actively seek to
\ncensor our knowledge of this.\r\n

\r\n __________________
\r\n "We can judge the heart of a man by his treatment of animals." ~Immanual Kant~
\r\n
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