Dr. Lawrence Cheng MD, CCFP(EM), MPHFunctional Medicine

We are at a pivotal point in the evolution of medicine where we are beginning to truly appreciate both the incredible power of modern technological medicine, but also its limits.  More than 70% of all chronic diseases, which account for the majority of the burden of illness in Western countries, are preventable by making better lifestyle choices.

The US spends about 3 trillion dollars each year on healthcare – 86% of it on preventable chronic disease. There is no end in sight for the rising cost of healthcare and increased demands for disease treatment.  Plus we have barely begun to see the demographic bulge of the “Boomers” and their needs.

I work in a busy downtown ER in Vancouver where we are gridlocked everyday.  We routinely treat 25 or more patients in the waiting room daily that should be in a stretcher space.  There is no more room. There is no more money.  Continuing to treat downstream end-organ disease, without addressing the prevention side of the equation, makes no sense whatsoever.  But in fact, that is what we have been doing. Governments spend a relatively small percentage of health care money on prevention.  Third-party insurers in the US are really beginning to invest in prevention because they realize that if they can prevent a disease, they will save costly payouts for treatments in the future.

Lifestyle medicine is based on epigenetics.  Epigenetics is showing us that the environment that we put ourselves in – what we eat, how we move, how we relate to ourselves and others, has more effect in many cases, than our disease risk from inheritance.  Genes are not our fate! The DNA is the hardcode blueprint but the epigenome is the software that makes the whole thing run.  Disease results from the interaction between your genes and your environment.  By changing the environment – you can significantly alter your disease risk.

Dr. Dean Ornish has pioneered some of the key studies that have shown conclusively that lifestyle programs can reverse heart disease.  Lifestyle medicine incorporates proper nutrition, optimal exercise and movement, stress reduction, mind-body therapies, and understands the importance of healthy relationships with oneself, others and connection with community.  The research is all out there….

Lifestyle medicine should be, in many if not most cases, the first line treatment for chronic diseases.  Only after we have optimized lifestyle factors as effectively as possible should we begin to incorporate pharmaceutical drugs or surgery.  Lifestyle interventions are not just for prevention but also for treatment of disease.  Many chronic diseases arise from imbalances in our core functional systems.  Most drug therapy does not address these core imbalances, but treats downstream effects and symptoms instead.

It is about time that lifestyle medicine is beginning to be seen as effective treatment for disease, as well as prevention.  When we address lifestyle factors for real, the side-effect is that the disease fixes itself!


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