A Randomized, Placebo-controlled, Triple-blind Study to Determine the Effect of Farlong Ginseng Plus® NotoGinseng Extract on Cholesterol and Blood Pressure

Objective: This randomized, placebo-controlled, triple-blind study examined the efficacy of 12 weeks of Farlong NotoGinseng™ (FNG) supplementation on LDL-C and blood pressure (BP) in otherwise healthy participants (n=95) with normal to mild hypertension and hypercholesterolemia. Methods: Lipid profile, BP, and endothelial vasodilation parameters were assessed at baseline and weeks 4, 8 and 12. Safety was assessed at screening and end of the study. The Therapeutic Lifestyle Change (TLC) diet was followed during a 4-week run-in and throughout. Results: Participants on FNG had a 4.33% reduction in LDL-C at week 8 (p=0.045) and a 1.80% improvement in HDL-C at week 12. Those on placebo had a non-significant 1.37% HDL-C reduction at both weeks 8 and 12. The FNG group showed a 0.94% reduction in systolic (SBP) and a 0.16% reduction in diastolic BP (DBP) at week 12. The placebo group also had 0.5% and 1.24% increases in SBP and DBP, respectively. A total of 17.5% of participants supplemented with FNG had improvements in all three CVD risk factors (LDL-C, HDL-C and SBP) compared to 5.0% of those on placebo (p=0.040). A greater proportion of participants with borderline high baseline LDL-C had reductions in their CVD risk factors (p=0.037) with FNG. However, participants in the placebo group with similar LDL-C characteristics did not have improvements in either their BP or lipid profile. Conclusion: FNG was well-tolerated and may have a positive influence on reducing CVD risk by improving BP and lipid profile. Left unaddressed, those with CVD risk factors may progress to a more hypertensive and hypercholesterolemic state.

On the Prevalence of Autoimmune Disease Markers in a Working Population and its Relationship to Wellness

Background: Autoimmune disease prevalence is rising at an increasing rate. However, little research currently exists on pre-screenings for autoimmunity and early disease management. We propose wellness visits should include an autoimmune disease panel screening for autoantibodies at preclinical and clinical levels. Methods: A working population of individuals without formally diagnosed autoimmune disease underwent company-sponsored wellness visits. Wellness markers such as blood pressure and lipid measurements and an autoantibody panel were obtained during the visits. Participants were offered functional medicine information afterwards. Results: Seventy-eight participants completed the visits. One or more wellness marker “abnormalities” were seen in 97% (76/78) of participants. Each wellness marker’s frequency of abnormality ranged from 13–82% of the participants. Preclinical or clinical autoantibody levels were seen in 53% (41/78) of the “healthy” working population with no previous autoimmune disease diagnoses. Preclinical markers were seen in 21% (16/78)of participants and clinical markers were seen in 32% (25/78) of participants. At least one wellness screening abnormality was seen in 98% (40/41) of participants with positive autoantibody findings. At least 50% of participants with a specific wellness abnormality tested at the higher “clinically” significant autoantibody levels. Conclusion: Preliminary findings from this study suggest that the integration of an autoantibody panel in wellness visits may be beneficial. Individuals may also consider healthier living practices and proactive prevention of autoimmune disease pathogenesis through applications of functional medicine and therapeutic lifestyle change. Clinical marker findings in asymptomatic individuals raises a limitation in the usefulness of such a panel, and further research such as a placebo-controlled prospective cohort study with an intervention trial or serial testing of autoantibody prevalence is needed.

Managing Cardiovascular Risk Factors without Medications: What is the Evidence?

: In this era of potent medications and interventional cardiovascular (CV) procedures, the importance of beginning with and including therapeutic lifestyle change (TLC) is frequently forgotten. A major goal of this review article is to show and emphasize that modification of CV risk with nonmedication approaches makes an essential contribution to CV risk reduction. Available information on TLC and modifiable CV risk factors was reviewed and assessed. Modifiable major CV risk factors include diabetes mellitus, hypertension, hyperlipidemia, tobacco abuse, obesity, stress, and sedentary lifestyle. Age as a major CV risk factor is, of course, not susceptible to modification. A contribution to the control of CV risk factors can occur without the start of medications and there is proof of benefit for beginning with a nonpharmacological approach. TLC can benefit all of the major modifiable CV risk factors and there is good evidence for the additional benefit of supervised and group TLC. TLC includes physical activity, diet, and smoking cessation. Evidence for the benefit of TLC in reducing CV disease events is well established. However, medications must be added in those patients with higher CV risk to obtain maximum cholesterol reduction (lower is better for the low-density lipoprotein cholesterol) and good blood pressure control. The benefit of TLC is frequently forgotten in this era of potent medications and invasive procedures. The benefits of diet and physical activity are emphasized with supporting data. Many motivated patients can prolong their lives significantly by dedication to TLC. •Therapeutic lifestyle change (TLC) especially encompasses increased physical activity, healthy diet, and smoking cessation. •There is extensive proof for the benefit of TLC in contributing to cardiovascular (CV) disease prevention. •CV disease has strong metabolic and inflammatory components, both of which can be improved by TLC.

Establishing Competencies for Physicians Who Specialize in the Practice of Lifestyle Medicine

Purpose: This activity by the Expert Lifestyle Medicine Panel (ELMP) proposes a set of competencies for providers who specialize in the practice of lifestyle medicine (LM), focused on intensive therapeutic lifestyle change. Methods: ELMP invited a core consensus group consisting of 13 providers who specialize in LM and key stakeholders to develop, by consensus, a set of competencies for those specializing in the practice of LM based on the LM core competencies for primary care physicians published in 2010. Two ELMP members (JK and MCK) facilitated and moderated the consensus process conducted by email and teleconference. The competencies were emailed to the consensus group for comment and revision and, through an iterative process, full consensus was reached by the 13-member group. Competencies were organized into the 6 Accreditation Council for Graduate Medical Education and American Board of Medical Specialties (ACGME/ABMS) categories. Results: The final set of competencies consist of 34 competencies in the 6 ACGME/ABMS categories. Conclusion: This new set of competencies will provide guidance for the education, certification, and practice of lifestyle medicine by physicians and other health providers who specialize in the practice of intensive lifestyle medicine treatment.