Andrew Weil's Blog: Dr. Weil's Healthy Living Blog, page 10

Migraine Headaches, Without Aura

What Are Migraine Headaches?

Migraines are severe, disabling headaches that affect some 37 million men, women and children in the United States. Untreated, these headaches can last for hours and sometimes as long as three days. Fortunately, medical management of migraine has improved dramatically since the introduction in the 1990s of drugs that specifically target migraine pain. Some patients also benefit from taking other medications that can prevent the headaches, although finding the right one for an individual can be a lengthy process of trial and error. An integrative approach – combining the best of conventional treatment with evidence-based natural approaches – can help reduce the frequency and severity of attacks. 

What Are The Symptoms Of Migraine Headaches?

 The classic migraine is a one-sided severe, throbbing headache that may be accompanied by nausea, vomiting, and sensitivity to light and sound.

Before a migraine begins, affected individuals can experience premonitions or “prodromes” that can occur several hours or even a day or two before the headaches begin. While they indicate that a migraine is coming, they are not considered auras (visual and sensory changes that precede a headache). These premonitions may include feelings of elation or intense energy, carbohydrate cravings, excessive hunger or thirst, and sleepiness, irritability or depression.

Once a migraine begins, headache pain worsens with physical activity and usually interferes with normal functioning. The frequency and intensity of migraine vary from person to person. The headaches can occur from once or twice a year to several times a month.

What Are The Causes Of Migraine Headaches?

 The exact cause of migraine isn’t fully understood. There are no true nerves for pain in the area where the headaches are experienced. Pain and discomfort of this nature ultimately arise from rapid dilation and possible inflammation of blood vessels in the head.

Some researchers believe migraines originate from functional changes in the trigeminal nerve, one of the cranial nerves that houses a major pain pathway. Others think these headaches are due to imbalances in the neurotransmitter serotonin, which regulates pain messages transmitted through the trigeminal nerve.

The vascular instability that is the immediate cause of migraine is influenced by many factors. Food sensitivity can play a role – specific foods trigger attacks in many people who have these headaches. Hormonal fluctuations can be a factor in women. While pregnancy tends to prevent migraines, birth control pills can trigger them. Both stress and heredity play a role.

Typical food triggers include aged cheeses and processed meats (particularly pepperoni and hot dogs); peanuts; bread and crackers containing cheese as well as any strong-flavored cheeses; broad beans, peas, and lentils; as well as beverages containing caffeine and chocolate. Wine is another culprit (red usually is more problematic than white). Fermented foods including soy sauce and miso have been implicated, as have some fish, including sardines, anchovies, and pickled herring. Other foods linked to migraines include avocados, bananas, citrus fruits, figs, raisins, red plums, and raspberries.

Food additives that may play a role include nitrates and nitrites (in processed meats), yellow food coloring, and monosodium glutamate (MSG), used in some canned or processed foods, as well as in Chinese foods and soy sauce.

Non-food migraine triggers include fatigue, lack of sleep (or sleeping too much), missing meals, changes in barometric pressure, and changes in altitude. Strong odors, such as those of paint, gasoline or heavy perfumes, and bright flashing lights can also trigger migraines. But not everyone has a clear trigger for the headaches.

Prevention Of Migraine Headaches

 New research from Italy has shown that for obese migraine sufferers, weight loss is associated with significant reductions in the frequency, severity of pain, and disability associated with migraines, as well as the duration of the attacks. This finding came from an analysis of 473 patients in 10 studies by researchers from Italy’s University of Padova. The improvements weren’t associated with the degree of obesity at the outset or the amount of weight lost.

 Certain medications can help reduce the frequency, severity and duration of migraines. These include beta-blockers, calcium channel blockers and other anti-hypertensives that can help regulate blood vessel tone and activity. These drugs also may increase the effectiveness of other medications used to relieve migraines. Certain antidepressants can help prevent migraines, as can the anti-seizure drugs Depakote, Neurontin and Topamax.  Side effects may include dizziness, drowsiness, lightheadedness, stomach upset, and weight gain or even weight loss (in the case of Topamax). Doctors may recommend taking preventive medications daily if migraines aren’t being adequately treated or if a predictable, but unavoidable, trigger is approaching.

Acupuncture may be helpful in reducing the frequency of migraines without aura. A study from China published in JAMA Internal Medicine in April 2017 found that when performed by licensed acupuncturists with at least five years of training and four or more years of clinical experience, acupuncture led to a decline in the average number of migraines from 4.8 per month to three per month, 20 weeks after receiving five acupuncture treatments weekly.

Conventional Treatment Of Migraine Headaches

Non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen are considered first-line treatments for migraines. Some over-the-counter drugs marketed specifically for migraines contain these compounds in combination with acetaminophen and caffeine. They can be effective for mild or intermittent headaches, but if taken frequently or for long periods of time, can lead to ulcers, gastrointestinal bleeding and “rebound headaches” – a headache that is just as strong, or worse, that develops when the medicine is withdrawn.

A number of prescription medications are used to relieve or prevent migraines. Triptans are very effective when taken at the beginning of an attack. They come in pill form but also are available in nasal spray and injectable forms. Although triptans are drugs of choice for severe migraines, they have side effects that should not be discounted, especially in patients with heart disease or high blood pressure. Triptans cause blood vessels to constrict, which counters the dilation that causes the pain. Side effects can include nausea, dizziness and muscle weakness. Rarely, if vessels narrow too much, stroke and heart attack can occur in susceptible individuals. Until an individual’s response to triptans is established, it is important to be under close medical supervision when using these drugs.

The drug ergotamine combined with caffeine has been used to prevent and treat migraines for more than 60 years. These preparations work by preventing blood vessels in the head from dilating. While they are less expensive with fewer side effects than triptans, they are not as effective.

In 2018 the FDA cleared a handheld vagus nerve stimulator for use in treating migraines in adults. It is meant to be placed over the vagus nerve in the neck within 20 minutes of the onset of pain. Studies have shown it to be effective.

In January 2019 the FDA approved TOSYMRA, a nasal spray for treating migraine with or without aura in adults. In one of the studies that led to approval, 43.8 percent of participants were pain free two hours after using the spray, and other symptoms, including nausea and sound and light sensitivity, had resolved among 70.7 percent of them.

Anti-nausea drugs are also commonly used in combination with other treatments, and medications that combine the sedative butalbital with aspirin or acetaminophen have been used in the past to treat migraine attacks. Some combinations include caffeine. These medications pose a high risk of rebound headaches and withdrawal symptoms and should be used infrequently.

In addition, medications containing narcotics such as codeine and hydrocodone often are used to treat severe migraine pain (often in urgent care settings or when people can’t tolerate triptans or ergotamines). These drugs are habit-forming, can cause rebound headaches – and should be used only as a last resort.

What Does Dr. Weil Recommend For Migraine Headaches?

Dr. Weil first recommends eliminating consumption of coffee (including decaffeinated coffee) as well as all other sources of caffeine including any over-the-counter or prescription drugs that contain it. Once you are completely off caffeine, Dr. Weil suggests trying coffee as an immediate treatment for migraine. Drink one or two cups of strong coffee at the first sign of an attack, then lie down in a dark, quiet room.

Try to identify and eliminate dietary triggers of migraine and also avoid all artificial sweeteners, including aspartame (NutraSweet and Equal).

He also suggests experimenting with the herb butterbur as a migraine preventative. This plant (Petasites hybridus), native to Europe, northern Africa and southwestern Asia has been clinically studied. Results of a small study published in the May 2000, issue of the journal Headache showed that an extract of butterbur root significantly reduced the frequency of migraine attacks among the 58 patients participating. If you decide to try it, avoid the crude herb, which may contain toxic pyrrolizidine alkaloids (PAs). Instead, choose PA-free butterbur extracts standardized to contain a minimum of 7.5 mg of petasin and isopetasin. The adult dosage ranges from 50-100 mg twice daily with meals. Side effects are rare.

He also suggests trying 100-150 mg daily of feverfew (Tanacetum parthenium), standardized to contain at least 0.2 percent parthenolides. This herb helps prevent the release of substances that dilate blood vessels in the head. You can take it indefinitely.

Another option is coenzyme Q10 (CoQ10). A study published in 2005, found that CoQ10 was superior to a placebo in preventing migraines. Researchers tested CoQ10 in a group of 43 patients, about half of whom received a placebo. Of those who took CoQ10, 50 percent reported significantly reduced frequency of headaches compared to only 14 percent of those who took the placebo. Dosage of CoQ10 in the trial was 100 mg three times daily.

Dr. Weil also regards vitamin B2 (riboflavin) and magnesium as helpful. The recommended dose of riboflavin is 400 mg daily – a high dose, which needs to be prescribed by a physician. For magnesium (citrate, gluconate or chelate, start with 100 mg daily) start with 200 mg twice a day and increase to 400 twice a day if necessary.

He suggests first trying these therapies individually for six to eight weeks to see if they’re helping you before moving on to the next.

You also can also take advantage of the mind-body connection by taking a course of biofeedback, which – with practice – can enable you to influence the part of the nervous system that regulates blood flow. Once you master this technique by learning to warm your hands, you can use it as a tool to abort a headache at the start of an attack.

Finally, if you continue to have attacks, Dr. Weil suggests trying to change the way you think about the headaches. Migraine is like an electrical storm in your head – violent and disruptive, but leading to a calm, clear state in the end. You may, upon reflection, discover that it is not so bad to let yourself have a headache once in a while. It is a good excuse to drop your usual routine and go inward, letting accumulated stress dissipate. As you come to accept migraines in this way and see them as serving a purpose in your life, you may not experience them so frequently.

Source:

Ling Zhao et al, “The Long-term Effect of Acupuncture for Migraine Prophylaxis A Randomized Clinical Trial,” JAMA Internal Medicine, April 2017, doi:10.1001/jamainternmed.2016.9378

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The Legacies of Spring

Celebrating Mothers’ Day &

Commemorating Memorial Day

Reflection 1: Celebrating Mothers’ Day

Most of us didn’t really know our mothers beyond their roles. If they’re gone, we may experience regret and an unending yearning to know who they were: what mattered to them, what and whom they valued and loved, their disappointments and pain, their successes and joy, and their hopes and dreams for us.

As Mothers’ Day approaches, we can turn a Hallmark moment into something meaningful. We can celebrate and honor our mothers, and make progress in healing what is often a complicated relationship.

Taking Action:

Reflect about and choose a favorite story about your mother and your appreciation of her.

“In search of my mother’s garden,  I found my own.”

-Alice Walker

Sit in a comfortable chair with your favorite cup of tea or coffee. Set your timer for just 15 minutes, write your story, and set it aside for a day or so. Then read it aloud to yourself, and edit it to make sure it conveys the celebration in your heart, not whether the syntax or punctuation is perfect.
If your mother is alive, give the story to her as a gift this Mothers’ Day. Read it aloud to her and give her a copy written in your own hand (even if you wrote it on your computer). Take the opportunity to have a conversation about this story or what it elicits, and take time to ask and listen to your Mother’s memories and stories as well.
If your mother is not alive, celebrate her memory by reading your story to those who are honoring you this Mothers’ Day. (And include it in your legacy documents, preserving the story as a tribute to her and for future generations who never knew her.

“May your legacy writing open your heart in true celebration of your mother, the legacies you received from her, and to celebrate your own mothering.”

-Rachael Freed

Reflection 2: Commemorating Memorial Day

In theory, Memorial Day is to honor the memories of those who sacrificed their lives in military service for our country. In practice, some visit cemeteries to plant flowers at family graves, but typically we celebrate this long weekend by opening swimming pools and beginning the bar-b-q season.

As a society, we value or are seduced away from our values by speed, by instant communication around the globe and unending streaming distractions.. We’re so busy doing – persuaded that what we do will give us meaning. If we stop long enough to take a breath, which is the opportunity of a holi-day (holy) day, we realize what we really yearn for is intimacy, connections that tether us to earth, community, and to each other.

Our deepest connections and fondest memories may be bound up with those who are no longer living. Intimate connections are not limited to life.

With Memorial Day on the calendar we can make the secular sacred, naming, remembering, communicating with, and preserving memories of family members now gone. Transform your Memorial Day into a holi-day!

Taking Action:

Consider inviting anyone at the pool party or bar-b-q to share memories of a family member who has died: for example: “Tell me about someone you miss on this Memorial Day.” This opens the door to stories of times before our own, and nourishes everyone with memories and family intimacy. An anonymous writer said it best:

“When someone you love becomes a memory,  the memory becomes a treasure.”

Here are simple, open-ended suggestions indicating your interest in others’ memories. Watch for the sparkle of joy as the memory is shared, for the healing tears that have been held so long, perhaps for a smile just saying the person’s name aloud…

Talk about family tradition recalling the lost from earlier times
Share memories about your loved ones who served in wars
What memories do you have of those in your extended family who sacrificed their lives in service to our country?
How did the war affect you and your family’s daily life (opportunities and choices), your hopes for the future?

“Wishing you a “holi” Memorial Day, one filled with the riches of memories and community as you remember your loved ones.”

– Rachael Freed

Rachael Freed, LICSW, is a senior fellow, Earl E. Bakken Center for Spirituality & Healing, University of Minnesota, and is the author of Your Legacy Matters and Women’s Lives, Women’s Legacies: rachael@life-legacies.com, and www.life-legacies.com.

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The Legacy Of Immigration

Not long ago I witnessed a citizenship ceremony: American and Minnesota flags waving proudly as 174 new citizens from 51 countries were marched in by local fire and police; were welcomed by our local mayor, and a state judge administering the oath of allegiance. The judge shared when and from where his own grandparents arrived and became citizens, noting that we all (except for our Native Peoples) have unique stories and that each of their naturalization stories of today must be preserved for their children and grandchildren.

“The story of my life is always embedded in those communities from which I derive my identity. I am born with a past. What I am, therefore, is in key part what I inherit, a specific past that is present to some degree in my present. I find myself part of history and that is generally to say, whether I like it or not, whether I recognize it or not, one of the bearers of a tradition.”

– Alasdair Chalmers MacIntyre

As they swore their allegiance to America and gave up allegiance to their native country, he reminded them that that did not mean giving up their histories and heritage from their native lands. He told them that beyond “their” families “we” are all enriched when they continue to celebrate and teach their young their native traditions, sing their songs, dance their dances, speak their languages, and prepare their foods: That diversity has been the strength of America and will continue to be.

He concluded that their rights, protections, and responsibilities of being Americans – from this moment going forward – are the same rights, protections, and responsibilities as Americans born here. Amid the tumultuous applause from families, friends, and witnesses, the ceremony closed with the beautiful singing of “America the Beautiful.”

As I walked home through the park, I was uplifted and hopeful again. There is goodness in our world; there is respect for diversity and the promise of human dignity and freedom. I wish all of you reading this today could have been sitting with me at this amazing ceremony – feeling humility and pride in the promise of America as we face the realities of our troubled times.

Although we are living in a world in which conversation has become social media, in which families who sat by the fire on cold winter evenings passing forward family history, stories, and values – the legacy of oral tradition – are no more, there are still naturalization ceremonies taking place all over our land. There is the energy of the love of freedom, of the promises that America still provides. What Emma Lazarus, descendant of immigrants, wrote in 1883, to be engraved on the base of the new Statue of Liberty, is as meaningful in 2019 as at the turn of the 20th century:

“Give me your tired, your poor,

Your huddled masses

Yearning to be free . . . .”

Taking Action:

If you are a naturalized American citizen, make time to reflect and write your story of emigrating–immigrating and becoming an American citizen – to celebrate it for yourself, and to pass it on to future generations.
If there are people in your family who know your ancestors’ immigration stories, have conversations with them, and record this part of your family history as a part of your legacy for younger generations.
Reach beyond your comfort level to communicate with someone different from you. Share how you got “here” wherever that is, and ask them to share their story with you.
Please don’t take America for granted – think about your own and others’ immigrations. Talk about it with others; learn about it from others. Do what you can to protect America’s freedoms for all people. Most important, don’t turn your back on this powerful legacy that affects all of us.

“May you experience the blessing of your immigration history and pass it forward as a powerful part of your legacy.”

– Rachael Freed

This 2019 Tips & Tools is dedicated to remembering the 907 Jewish refugees seeking asylum, who sailed the SS St. Louis from Hamburg and were refused entry to Cuba and the US, although they carried legal visas. Most died at the hands of the Nazis after being returned to Europe in 1939.

Rachael Freed, LICSW, is a senior fellow, Earl E. Bakken Center for Spirituality & Healing, University of Minnesota, and is the author of Your Legacy Matters and Women’s Lives, Women’s Legacies: rachael@life-legacies.com, and www.life-legacies.com.

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Foods You Don’t Have To Buy Organic: The Clean 15

I am pleased to have an ongoing partnership with the Environmental Working Group (EWG), a nonprofit organization that advocates for policies that protect global and individual health. Specifically, I am honored to help EWG spread the word about one of its most valuable pieces of research – its Shopper’s Guide to Pesticides in Produce. The 2019 version is based on the results of ongoing pesticide tests performed on produce and collected by federal agencies.

Nearly all of the data used took into account how people typically wash and prepare produce – for example, apples were washed and bananas peeled before testing. Of the fruit and vegetable categories tested, the following “Clean 15” foods had the lowest pesticide load, and consequently are the safest conventionally grown crops to consume from the standpoint of pesticide contamination:

The Clean 15 (2019)

Avocados
Sweet corn*
Pineapples
Sweet peas (frozen)
Onions
Papayas*
Eggplants
Asparagus
Kiwis
Cabbage
Cauliflower
Cantaloupes
Broccoli
Mushrooms
Honeydew melons

* A small amount of sweet corn, papaya and summer squash sold in the United States is produced from genetically modified seeds. Buy organic varieties of these crops if you want to avoid genetically modified produce.

Why should you care about pesticides in your fruits and vegetables? The EWG points out that there is a growing consensus in the scientific community that small doses of pesticides and other chemicals can have adverse effects on health, especially during vulnerable periods such as fetal development and childhood.

Here’s a video in which I address the importance of avoiding pesticides.

To this list, I would add one caveat: When it comes to pesticide use, there is more to consider than just the residues that are ingested by the consumer. Although peeled foods such as mangoes, avocadoes and kiwis may spare the consumer from significant pesticide exposure, it is possible that large amounts of pesticides and herbicides are used on the farms from which these originate, contaminating groundwater, promoting erosion and otherwise damaging local ecosystems. To help promote the health of the planet as well as your own health, it’s best to buy organic whenever possible, including when you are purchasing the foods listed above.

At the opposite end of the contamination spectrum, check out the list of Foods That You Should Always Buy Organic, also known as the “Dirty Dozen Plus.”

Updated: March, 20th, 2019

SOURCE:

ewg.org/foodnews/clean_fifteen_list.php

Reviewed by Benjamin S. Gonzalez, M.D., May, 2016.

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Foods You Should Always Buy Organic: The Dirty Dozen Plus

I am pleased to have an ongoing association with the Environmental Working Group (EWG), a nonprofit organization that advocates for policies that protect global and individual health. Specifically, I help EWG spread the word about one of its most valuable pieces of research – its Shopper’s Guide to Pesticides in Produce. The 2019 version is based on the results of ongoing pesticide tests performed on produce and collected by federal agencies.

Nearly all of the data used took into account how people typically wash and prepare produce – for example, apples were washed and bananas peeled before testing. The following “Dirty Dozen Plus” had the highest pesticide load, making them the most important to buy organic versions – or to grow them organically yourself.

The Dirty Dozen Plus (2019)

Strawberries
Spinach
Kale
Nectarines
Apples
Grapes
Peaches
Cherries
Pears
Tomatoes
Celery
Potatoes
Hot peppers

Why should you care about pesticides? The EWG points out that there is a growing consensus in the scientific community that small doses of pesticides and other chemicals can have adverse effects on health, especially during vulnerable periods such as fetal development and childhood. Here’s a video in which I address the importance of avoiding pesticides.

Also keep in mind that maintaining your family’s health is not the only reason to choose organic food. Pesticide and herbicide use contaminates groundwater, ruins soil structures and promotes erosion, and may be a contributor to “colony collapse disorder,” the sudden and mysterious die-off of pollinating honeybees that threatens the American food supply. Buying or growing organic food is good for the health of the planet.

At the opposite end of the contamination spectrum, check the list of Foods That You Don’t Have to Buy Organic, also known as the “Clean 15.”

Updated: March, 20th, 2019

SOURCE:

ewg.org/foodnews/dirty-dozen.php

Reviewed by Benjamin S. Gonzalez, M.D., May, 2016.

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Dr. Weil’s Gift To The University of Arizona

Joining Dr. Weil in this image: UA President Robert C. Robbins, M.D., UA Senior Vice President for Health Sciences Michael D. Dake, M.D., and Andrew Weil Center for Integrative Medicine Executive Director Victoria Maizes, M.D.

March, 2019 – Dr. Weil has donated $15 million to the University of Arizona for the expansion of the Center for Integrative Medicine, which will be renamed in his honor as the Andrew Weil Center for Integrative Medicine. Dr. Weil’s gift, which supplements $5 million he donated earlier, also will establish an endowed chair in integrative medicine, another for research in integrative medicine, and an endowed program fund for integrative medicine. It will help build modern new quarters for the Center on campus.

Here are Dr. Weil’s thoughts about his legacy, his gift and his vision for the future of healthcare:

This gift marks the high point in my career. It’s been 25 years since the Center in Integrative Medicine was established at the University of Arizona with the aim of redesigning medical education. I believed then – and still do – that we can impact and improve our nation’s struggling health care system by training physicians to focus on the innate healing potential of humans. Integrative medicine combines the best practices of modern medicine with an emphasis on lifestyle factors that influence health (nutrition, physical activity, etc.)nutrition, mind-body interventions, spirituality, and natural therapies.

As you might imagine, 25 years ago there was a lot of skepticism about this approach. Fortunately, times have changed, and the importance of good nutrition and a healthy lifestyle are accepted as mainstream by most practitioners and by the estimated eight million patients our program has directly and indirectly served. A growing body of scientific evidence supports the use of botanical remedies, mind/body therapies, acupuncture and other “alternative” treatments.

In the beginning, the program consisted of a two-year residential fellowship that trained four physicians a year. Not surprisingly, people couldn’t imagine how I was going to change medicine by training so few people, but that modest start gave us a chance to develop a solid curriculum. We graduated 35 fellows from that initial program, some of whom are now in influential positions at institutions throughout the country. They’re directing integrative medicine centers at other universities and have written textbooks on the subject. Today we train 160 physicians (and nurse practitioners and physicians’ assistants) a year via a 1,000-hour online fellowship and have 1,800 graduates in all states and in 15 other countries. There is now a waiting list for the fellowship.

Also, a condensed curriculum of 200 hours has been adopted by 74 residency programs in the US and Canada (as well as in Taiwan and Germany). But there’s still a long way to go.  Our goal is to have our curriculum become a required, accredited part of residency training in all fields of medicine. That would mean that every psychiatrist, dermatologist, gastroenterologist, and other specialist would have a solid grounding in nutrition, lifestyle medicine, mind/body interactions, and all the other important subjects now omitted from conventional medical education.

Through all our 25 years, the Center for Integrative Medicine has been self-sustaining through tuition. We’ve received some federal funds and have been helped by private philanthropy, but have never had state money. Even so, we have become the world leader in integrative medicine education. For a long time, we’ve wanted a home and financial stability. Visitors come from all over the world eager to see our center, and all we have to show them is a small house some distance from the medical campus. We have other offices some distance away, but nothing centralized. That will change when we have our new building, probably in 2022.

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Andrew Weil Center For Integrative Medicine (staff) | Photo Courtesy of the University Of Arizona

And in 2020, the Center for Integrative Medicine will open an integrative medicine primary care clinic in Tucson in partnership with Banner Health, one of the largest nonprofit health care systems in the U.S. If we can demonstrate – as I believe we can – that integrative medicine produces better outcomes for common health conditions at lower cost, it could become a new model for health care throughout the country. I know that integrative medicine is the way of the future. And I look forward to the day when we’ll be able to drop the word “integrative.” What we practice will simply be good medicine.

I hope my gift inspires others who share my vision for more effective and less costly healthcare to step up and donate.

Andrew Weil, M.D.

For more information:

Learn more about the Andrew Weil Center For Integrative Medicine
Read the press release.
Watch a video of the press event (23 minutes):

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Dr. Andrew Weil Commits $15M To Integrative Medicine

Integrative Medicine Pioneer Dr. Andrew Weil Commits $15M to Name UA Center for Integrative Medicine, Bringing Total Giving to $20M

Gift commitment also establishes two endowed chairs and provides permanent endowment fund to support academic mission of Andrew Weil Center for Integrative Medicine.

March 12, 2019

TUCSON, Ariz. – Integrative medicine pioneer, best-selling author and philanthropist Andrew Weil, M.D., has committed $15 million to name the Andrew Weil Center for Integrative Medicine – adding to his previous gifts totaling $5 million – ensuring the UA is the world’s nexus of integrative medicine education, research and innovation.

Weil made the announcement today at a news conference. Joining him were UA President Robert C. Robbins, M.D., UA Senior Vice President for Health Sciences Michael D. Dake, M.D., and Andrew Weil Center for Integrative Medicine Executive Director Victoria Maizes, M.D.

In addition to naming the center, Weil’s commitment establishes the Andrew Weil Endowed Chair in Integrative Medicine, the Andrew Weil Endowed Chair for Research in Integrative Medicine and the Andrew Weil Endowed Program Fund for Integrative Medicine. Both chairs will benefit from the UA’s Eminent Scholars Program, established to help the university recruit and retain top faculty. Through the program, donated funds are augmented in order to grow the endowment faster and to provide more immediate support than is typical with an endowed chair.

Dr. Weil: “This gift marks the high point of my career at the University of Arizona,” Weil said. “More than 20 years ago, with strong support from the dean of medicine and the Tucson community, we established the nation’s first Fellowship in Integrative Medicine with the aim to redesign how we educate our nation’s medical students, residents and fellows. We believed by doing this, we could impact our nation’s struggling health care system – so that physicians would focus on the innate potential of humans to self-repair, to heal themselves. In addition to the best practices of modern medicine, we emphasized nutrition, a healthful lifestyle, spirituality and mind-body interactions. Perhaps those concepts were seen as radical in some circles, but today they are accepted as mainstream by most practitioners and by the estimated 8 million patients our program has directly and indirectly impacted.”

Dr. Robbins: Robbins added, “The University of Arizona has long been recognized for its major innovations and groundbreaking spirit. Dr. Weil’s center is an excellent example of our willingness to take risks to benefit humankind. We know promoting a healthful lifestyle and taking greater responsibility for our own health just makes good sense. We owe Dr. Weil a debt of gratitude for making that obvious notion a significant component of our nation’s medical education, practice and research.”

Since its founding, the Andrew Weil Center for Integrative Medicine has sought to transform health care by creating, educating and supporting a community of practitioners that embodies the philosophy and practice of healing-oriented medicine. The center is internationally recognized for its innovative educational programs, evidence-based clinical practice and research that substantiates the field of integrative medicine and influences public policy.

Maizes, the center’s director since 2004, will be the inaugural holder of the Andrew Weil Endowed Chair in Integrative Medicine. Internationally recognized as a leader in integrative medicine, Maizes oversaw the growth of the center from a small program educating four residential fellows a year to a UA Center of Excellence training more than 500 residents and fellows annually. A graduate of Barnard College, Maizes received her medical degree from the University of California, San Francisco. She completed her residency in family medicine at the University of Missouri, Columbia and her fellowship in integrative medicine at the UA.

The inaugural holder of the Andrew Weil Endowed Chair for Research in Integrative Medicine is Esther Sternberg, M.D., director of research for the Andrew Weil Center for Integrative Medicine since 2012. Sternberg is internationally recognized for her research in brain-immune interactions and the effects of the brain’s stress response on health. She is founding director of the UA Institute on Place and Wellbeing, an interdisciplinary institute linking health professionals and design professionals to research and create spaces that support health and wellbeing. She received her medical degree and trained in rheumatology at McGill University in Montreal.

Weil’s gift also will fund the Andrew Weil Endowed Program Fund for Integrative Medicine, which will support the center’s teaching and research mission in perpetuity.

“Dr. Weil is a visionary who put the UA on the map for integrative medicine,” said John-Paul Roczniak, president and CEO of the UA Foundation. “These endowments honor his belief that healing-oriented medicine should be available to all and ensure that the impact of this important work continues to grow.”

Combining a Harvard education and a lifetime of practicing natural and preventive medicine, Weil founded the Center for Integrative Medicine at the University of Arizona in 1994. He holds the Lovell-Jones endowed chair in integrative rheumatology and is clinical professor of medicine and professor of public health. Weil is also a founder and co-owner of the growing group of True Food Kitchen restaurants. A frequent lecturer and guest on talk shows, he is an internationally recognized expert on medicinal plants, alternative medicine and the reform of medical education.

In 1997, Weil and the UA made medical history by establishing the world’s first curriculum in integrative medicine and launching a two-year residential fellowship that went on to serve as a national model for training physicians in integrative medicine. The two-year fellowship has been the cornerstone of the center’s educational programming and has graduated more than 1,800 fellows from throughout the world.

Today, alumni of the fellowship program are leading integrative medicine programs at such prestigious institutions as the Tufts Center for Complementary and Integrative Medicine, the University of Southern California Institute for Integrative Health, the Cleveland Clinic Wellness Institute and the University of Kentucky Integrative Medicine & Health program, among many others. Alumni also lead international initiatives in Israel, Canada, Brazil, Japan, Thailand, Korea, Pakistan and other countries.

Additional information about the Andrew Weil Center for Integrative Medicine:

The center co-founded the Consortium of Academic Health Centers for Integrative Medicine –with Duke University and the University of Massachusetts – which has more than 70 member institutions engaged in clinical, educational and research programs in integrative medicine.
The center’s research program, led by Sternberg, is at the forefront of integrative medicine scientific inquiry, seeking to demonstrate cost-effectiveness of integrative primary care, converting scientific findings to actionable integrative medicine practices and tools.
The Integrative Medicine in Residency program is a 200-hour, competency-based, interactive online curriculum designed for incorporation into primary care residency education. Launched in 2008 with eight sites, the program has expanded to 74 sites internationally and boasts nearly 1,500 alumni.

For more information, please go to: https://integrativemedicine.arizona.edu/

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Media contact:

George D. Humphrey, MA

UA Health Sciences

520-626-7255

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Dr. Weil’s Guide To Popular Diets

Do you have a diet-related health problem or are you at risk of developing a health concern that might be avoided by changing eating habits? Choosing an eating plan best suited to your needs can be confusing. If your aim is to achieve a healthier lifestyle, you can now find Dr. Weil’s Guide To Pupoular Diets on this site. Many of these dietary strategies have shown promise in helping prevent chronic diseases and increasing longevity, as well as lowering the risk of cancer and heart disease, reducing high blood pressure, helping control irritable bowel syndrome and lowering the risk of dementia. Check out the preview below to identify ones that best fit your health needs or can help you avoid specific risks. You then can link to a full review of each.

Dr. Weil’s Guide To Popular Diets To Benefit Your Health:

Anti-Inflammatory Diet: This plan is not a diet in the popular sense – it is not intended as a weight-loss program (although people can and do lose weight on it), nor is the Anti-Inflammatory Diet an eating plan to stay on for a limited period of time. Rather, it is way of selecting and preparing anti-inflammatory foods based on scientific knowledge of how they can help your body maintain optimum health.

DASH Diet: Designed to help lower blood pressure without the need for medication, this diet is also linked to lower risks of breast, colorectal and prostate cancer as well as diabetes. It emphasizes fruits, vegetables and whole grains.

Flexitarian Diet: Emphasizes plant-based foods but allows occasional consumption OF meat, chicken or fish. Health benefits: a lower risk of heart disease and hypertension.

Low FODMap: Designed for people with irritable bowel syndrome (IBS). It eliminates foods commonly associated with IBS symptoms in order to help identify those that are responsible in individual cases.

Ketogenic Diet: Developed as a treatment for drug-resistant epilepsy, particularly in children, it is now very popular for weight loss and general fitness. On this plan 75 percent of calories come from fat, 20 percent from protein and five percent from carbohydrate.

Macrobiotic Diet: Macrobiotics is viewed as a way of life, not simply a diet. Its philosophy teaches that good health and long life depend on proper food choices, predominantly whole grains: brown rice, barley, oats, corn, rye, wheat and buckwheat, as well as fish, whole soy foods, and other legumes, in addition to land and sea vegetables.

Mediterranean Diet: A composite of the traditional cuisines of Spain, southern France, Italy, Greece, Crete and parts of the Middle East, this way of eating emphasizes fruits and vegetables, high quality dairy products and fish. Shifting from a standard Western diet to the Mediterranean diet may help promote weight loss. Health benefits: lower risk of death from heart disease and cancer.

MIND Diet: This combination of the DASH diet and the Mediterranean diet is designed to help prevent age-related dementia and Alzheimer’s disease. It emphasizes foods including whole grains, fruits, non-starchy vegetables, nuts, legumes and seafood that have demonstrated some evidence of improving brain health.

Paleolithic Diet or Paleo Diet: This is an attempt to recreate the dietary habits of humans living during the Paleolithic era, 2.5 million to 10,000 years ago. It emphasizes vegetables, nuts and seeds and some fruit, primarily berries, in addition to wild-caught fish, organic eggs and free-range beef and chicken. All processed foods are excluded.

Raw Food Diet: The raw food diet entails restricting yourself to foods that haven’t been cooked or processed in any way. This limits adherents to eating mostly raw fruits and vegetables, along with seeds and nuts, all of which should be part of any healthy diet. However, maintaining the diet long term is associated with a risk of abnormally low bone mass, a sign that followers may be vulnerable to osteoporosis due to a very low intake of calcium and vitamin D.

Vegetarian Diet: Vegetarian diets tend to be lower in calories, saturated fat and cholesterol and higher in fiber, potassium and vitamin C than most other ways of eating. Health benefits: Vegetarians often weigh less than meat-eaters, have lower levels of LDL (“bad”) cholesterol and lower rates of heart disease and cancer.

Vegan Diet: The vegan diet eliminates all foods of animal origin – including eggs, dairy products and honey, as well as meat, fish and poultry. Health benefits: Vegans generally have a lower body mass index and weigh less than non-vegan counterparts. However, the diet may not provide adequate amounts of some essential micronutrients.

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MIND Diet

What Is The MIND Diet?

MIND stands for “Mediterranean-DASH intervention for Neurodegenerative Delay.” It was developed in an effort to lower the risk for Alzheimer’s disease. A study supported by the National Institute of Aging, part of the U.S. National Institutes of Health, found that this diet reduced the incidence of Alzheimer’s by 53 percent among people who followed it closely and by 35 percent among those who followed it moderately well. These results were published in 2015. Later investigations showed that the MIND diet appears to work better than the Mediterranean diet or the DASH diet individually for lowering the risk of cognitive decline.

The MIND diet was developed by Rush University Medical Center nutritional epidemiologist Martha Clare Morris. It emphasizes foods that positively influence brain health, such as whole grains, fruits, non-starchy vegetables, nuts, beans and legumes, and seafood. The diet limits or eliminates red and processed meats, added salt, sweet foods and drinks, and refined grains.

How Healthy Is The MIND Diet?

Both the Mediterranean and DASH diets are considered extremely healthy. The former is linked to lower risk of death from heart disease and cancer as well as to improvements in brain function and lower rates of chronic disease and offers protection from Alzheimer’s disease. In addition to helping lower blood pressure, the DASH diet can help reduce blood levels of homocysteine, a toxic amino acid. People with high blood levels of homocysteine have twice the normal risk of developing Alzheimer’s disease.

How Popular Is It?

Although the MIND diet has received much favorable publicity, the extent of its popularity is unknown. The Alzheimer’s Association has featured it on its website, and a U.S. News and World Report panel of experts ranked it fourth healthiest OF 41 diets reviewed as well as the fourth easiest diet to follow, the fourth best heart healthy diet and the fourth best for healthy eating generally. An ongoing three-year study of the MIND diet at Rush University and the Harvard T.H. Chan School of Public Health will examine its effects on cognitive decline and brain health in a group of 600 participants between the ages of 65 and 84 who have a family history (but no personal history) of dementia, are overweight or obese and have poor eating habits.

General Principles Of The MIND Diet

Since there are no treatments to reverse Alzheimer’s disease or other forms of dementia, we need strategies to help prevent them. The MIND diet with its focus on the effects of foods on brain health may be one such strategy.

What Can You Eat?

The MIND diet is very specific about what you can eat from day to day. It requires consuming:

At least three servings of whole grains daily
At least six servings of green leafy vegetables per week
At least one daily serving of another vegetable
At least two servings of berries per week
At least one serving of fish per week
At least two servings of poultry per week
At least four servings of beans per week
Five servings of nuts per week.

It also requires you to use olive oil as your primary cooking oil, and (if you drink alcohol) one glass of wine daily. Restrictions include less than one pat of butter or margarine daily, less than one ounce of cheese per week, less than 5 servings of pastries or sweets per week and less than 4 servings of red or processed meats per week.

How Many Calories On The MIND Diet?

Since the MIND diet isn’t specifically designed for weight loss, it doesn’t specify the number of calories you can consume daily. If you stick to it, however, you probably will consume fewer calories than beforehand since it eliminates processed and fried foods, and limits consumption of sweets and refined carbohydrate foods.

What Do Doctors Say?

Although research to date does suggest that the MIND diet can benefit the brain and prevent dementia, evidence from the ongoing study mentioned above will be a better indication of its effectiveness. Given that both the DASH diet and the Mediterranean diet on which the MIND diet is based are viewed as among the best eating plans for overall health, doctors are unlikely to view the MIND diet negatively. 

Dr. Weil’s Take On The MIND Diet:

Dr. Weil regards both the Mediterranean diet and the DASH diet as among the world’s healthiest ways to eat. He notes that most people like the Mediterranean diet because it doesn’t stint on flavor and offers a wide range of health benefits. He also notes that Alzheimer’s disease is linked to diets high in animal protein and low in fruits and leafy vegetables which are emphasized by the MIND diet. For people who may be at higher risk for Alzheimer’s disease and other forms of dementia, he thinks the MIND diet is a reasonable strategy and a good bet.

Source:

Martha Clare Morris et al, “MIND diet slows cognitive decline with aging,” Alzheimers & Dementia, September 2015, doi: 10.1016/j.jalz.2015.04.011

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Paleo Diet

What Is The Paleo Or Paleolithic Diet?

Also known as the Stone Age diet, the Hunter-Gatherer diet and the Caveman diet, this eating plan attempts to recreate the dietary habits of early human beings living during the Paleolithic era, dating from 2.5 million to 10,000 years ago, before the advent of farming. They mostly ate wild greens, tubers, fruits and nuts, all of which have abundant vitamins, minerals, and fiber, as well as fish and animal foods when they could. They managed without salt, sugar, dairy foods, vegetable oils, and grains. Our distant ancestors had a healthier way of eating than we do, although it is unlikely that we would find many of the foods they ate appealing. Along with greater physical activity, their diet probably protected them from diabetes, heart disease, and other chronic diseases that affect us. (Of course, their life expectancy wasn’t close to what ours is today.) 

How Healthy Is The Paleo Diet?

With its avoidance of processed foods and abundant vegetables, fruit, nuts and high-quality protein, the Paleo diet has some useful healthy guidelines. By eliminating whole grains and legumes, however, you lose out on good sources of fiber and by eliminating dairy products your intake of calcium may not be adequate. Even so, studies comparing the Paleo diet to the Mediterranean diet have shown that eating Paleo can lead to more weight loss, improved glucose tolerance, better control of blood pressure, lower triglycerides and better management of appetite. There have been no clinical trials, however, to evaluate the long-term health benefits and risks of the Paleo diet.

How Popular Is It?

According to the 13th annual food and health survey from the International Food Information Council, the Paleo diet was the second most popular eating pattern in the United States in 2018, down from the most popular diet in 2013 according to other sources. The 2018 survey found that seven percent of Americans were going Paleo. 

General Principles Of The Paleo Diet

The Paleo diet is based on the “discordance hypothesis,” which holds that today’s chronic diseases result from dietary and activity patterns that differ from those of our hunter-gatherer predecessors. Compelling as this hypothesis may appear, some archeological research indicates that long before the advent of farming, some humans were eating wild grains as long as 30,000 years ago, and more recent genetic changes may have made it easier for us to digest and assimilate dietary starches.

What Can You Eat?

The modern-day version of the Paleo diet encourages consumption of lots of vegetables, nuts and seeds and some fruit, primarily berries, plus high-quality protein in the form of wild-caught fish, organic eggs and free-range beef and chicken. You also can use olive oil and oil from nuts, primarily walnut oil. Strictly following the diet requires eliminating wheat, soy, sugar, legumes, peanuts, starch, sugar and caffeine.

How Many Calories On The Paleo Diet?

You may be able to lose weight on the Paleo diet without counting calories. Eliminating processed foods, fast foods, sugar, and other quick-digesting carbohydrates favors weight loss, but if you consume a lot more meat than you’ve been accustomed to, you could gain. A Swedish study published in 2008 found that 14 medical students (5 male and 9 female) who followed a Paleo diet for three weeks lost 5 pounds and about a half inch of waist circumference on average. Their systolic (top number) blood pressure dropped by 3 mm of mercury. Another study, published in 2014, compared the effects of a Paleo diet with those of a standard low-fat diet on 70 obese postmenopausal women.  The Paleo group lost an average of 14 pounds of fat in six months compared to 6 pounds for those on the low-fat diet. Over a year, the women in the Paleo group lost an average of 19 pounds compared to 10 pounds for those on the low-fat diet. Whether or not the diet can help you lose weight and keep it off depends on how committed you are; because it is so restrictive, many people can’t eat the Paleo way for long.

What Do Doctors Say?

Medical opinions on the Paleo diet vary. A panel of doctors and nutritionists assembled by U.S. News & World Report for its 2018 “Best Diets” issue were critical of the diet’s effectiveness for preventing cardiovascular disease and also found it difficult to follow. They ranked it 32 in ratings of 40 different diets. The upside is that switching from processed foods is a healthy change. But key to the purported benefits of a Paleo diet for our ancestors was their way of life – living outdoors, in nature, and being very active, something that few people in the modern world can faithfully replicate.

Dr. Weil’s Take On The Paleo Diet:

Dr. Weil agrees that strictly avoiding processed and manufactured foods is a worthy goal and feels that a Paleo regime can lead to better health. While he says there is no harm and some potential benefit in trying the Paleo diet, he believes the diet is too restrictive for most people to stick with long term. Instead, he feels that success is more likely for most people if they regard it as healthy direction, rather than as a strict set of guidelines from which one can never deviate. He favors inclusion of some whole grains and legumes. Another problem: wild game and grass-fed animals may be too expensive for many people.

Sources:

Caroline Mellberg et al, “Long-term effects of a Paleolithic-type diet in obese postmenopausal women: a 2-year randomized trial.” European Journal of Clinical Nutrition, March 2014, Doi:10.1038/ejcn.2013..290

Osterdahl et al, “Effects of a short-term intervention with a paleolithic diet in healthy volunteers.” European Journal of Clinical Nutrition, May 2008

Caroline Mellberg et al, “Long-term effects of a Paleolithic-type diet in obese postmenopausal women: a 2-year randomized trial.” European Journal of Clinical Nutrition, January 29, 2014.

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