Not long ago, I received a notice regarding a 14-day belly-fat study sponsored by Curves and the Health & Wellness Center of Alexandria, Virginia. I was curious to sample the services and facilities of Curves, so I responded to the advertisement. Also, a belly-fat study sounded like an excellent complement to the medical advise of my rheumatologist.
During a routine visit in September, my rheumatologist inquired as to my exercise level and food choices. My initial reaction was one of guilt for becoming increasingly sedentary. However, my very smart rheumatologist quickly changed the focus of the conversation. She explained that abdominal fat (adipose tissue) produces specific proteins or cytokines (TNF-a and Interleukin-1) which are involved in systemic inflammation (as is associated with rheumatoid arthritis).
Some of the newer drugs for RA, including Enbrel, Humira, and Remicade, work to counteract interleukins and TNF-a. However, MS patients are restricted from using these drugs due to MS-like neurological side effects. Thus the non-pharmaceutical, anti-inflammatory prescription for reducing the production of these cytokines is to focus on reducing abdominal fat through exercise and nutrition.
This puts me, the patient, in charge of using alternative or natural methods to control the symptoms and dangerous effects of chronic disease. I'd say that I'm fortunate in that several of my doctors welcome an integrative medicine approach to disease management; however, my health insurance doesn't. For example, I do not have insurance-covered access to licensed dietitians or physiotherapists, although their guidance and expertise would be invaluable in helping to limit the effects of chronic disease. Unfortunately, you must be diabetic to have dietitian services covered by insurance and the only approved treatment for obesity is the extreme solution of gastric-bypass surgery.
The Patient as CEO of Personal Health and Wellness
In an ideal patient-centered healthcare system, the individual (ie. patient, consumer, client, CEO of one's own body, whatever you prefer to call yourself) should seek to obtain the most accurate and appropriate information available with which to make decisions regarding his/her choices in achieving a healthy body or treating a specific disease or disorder.
Although the CEO of a corporation does not need to obtain an education or degree in electrical engineering to run a company which uses computers, modern lights, or copy machine technology, he would be wise to harness the expertise of those who do have the knowledge and skills to maintain the desired electrical or technical systems required to facilitate the functions of the corporation.
Likewise the patient does not need to have a medical degree to be wise enough to seek guidance and care from a qualified, educated, and licensed medical or health professional.
License vs. Certification
In general, a license is a government-issued permission allowing the recipient the privilege to conduct business or engage in an activity which is otherwise prohibited. A licensing board determines the conditions and limitations which must be met to allow participation in certain professions or activities. Certification differs from licensing in that it is not issued as a permission to engage in certain activities. Certification serves to set standards, educate practitioners, increase competency, and to verify completion of a specific course of study.
The difference between license and certification can be significant when the patient-CEO is seeking the advise of a qualified healthcare practitioner. For example, consider the difference between dietitian and nutritionist.
Dietitian vs. Nutritionist
Dietitians have a Bachelor's degree specializing in foods and nutrition, and have completed an accredited internship at a hospital, or a graduate degree associated with an accredited hospital. They must pass a national registration exam and maintain their registration through continuing education. As dietitians are members of a regulated profession, they are held accountable for their conduct and the care they provide.
The term 'nutritionist' is not a professionally-regulated term and there are no minimum qualifications for an individual to call himself a nutritionist. Some nutritionists may give their businesses fancy names like "The National Nutrition Clinic" or "International Nutrition Center," but the truth is anyone can open up shop as a 'nutritionist' -- including the 16 year-old kid at the health food store.
What is Complementary and Alternative Medicine (CAM)?
According to the National Center for Complementary and Alternative Medicine (NCCAM), a component of the National Institutes of Health, CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses. Some health care providers practice both CAM and conventional medicine.
While some scientific evidence exists regarding some CAM therapies, for most there are key questions that have yet to be answered through well-designed scientific studies -- questions such as whether these therapies are safe and whether they work for the diseases or medical conditions for which they are used. The list of what is considered to be CAM changes continually, as those therapies that are proven to be safe and effective become adopted into conventional health care and as new approaches to health care emerge.
- Complementary medicine is used together with conventional medicine. An example of a complementary therapy is using aromatherapy to help lessen a patient's discomfort following surgery.
- Alternative medicine is used in place of conventional medicine. An example of an alternative therapy is using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a conventional doctor.
- Integrative medicine combines treatments from conventional medicine and CAM for which there is some high-quality evidence of safety and effectiveness. Integrative medicine neither rejects conventional medicine nor accepts alternative therapies uncritically.
As part of the Department of Medicine at the University of Arizona Health Sciences Center in Tucson, the Program in Integrative Medicine seeks "to lead the transformation of healthcare by creating, educating, and actively supporting a community of professionals who embody the philosophy and practice of Integrative Medicine." Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount. Currently, there is no accrediting agency with the authority to endorse a comprehensive education in integrative medicine.
Integrative Medicine is not without critics as is evident in this post by Panda Bear, MD, this post at Respectful Insolence, and this post by The Physician Executive. And Musings of a Dinosaur discusses CAM here, here, and here. I would like to suggest that much research is being done which explains, or at least supports, the beneficial claims of some alternative approaches, including nutrition, acupuncture, deep tissue release, and others.
A book which I have found to be both highly educational and somewhat practical is "Prescription for Nutritional Healing" by Phillis A Balch, CNC and James F. Balch, MD. Research at NCCAM confirms many of the nutritional claims presented in this book now in it's 4th edition.
Back to the Curves/Health & Wellness Center Study
When I answered the advertisement, the woman on the phone told me that I needed to attend a Seminar on Monday night before beginning the study. Since I teach lessons every weeknight, I could not attend but was scheduled an appointment to see the doctor instead. I was told that the doctor would want to conduct a pre-study analysis which seemed reasonable to me.
At the Health & Wellness Center, a video of a lecture was playing in the waiting room. I found that a little annoying while trying to concentrate on filing out all of the paperwork and then reading the handout of recommended dietary guidelines. During the appointment, an assistant measured my weight and height (I was not asked to remove my shoes), asked for a urine sample in a non-sterile container (no instruction given or disinfectant wipes provided for a 'clean catch' sample), took my blood pressure while laying down and then while standing upright (no time elapsed to allow arm to recover between pressure readings), and finally a Heart Rate Variability test while laying down and then standing up (I was told this registered my heart's ability to respond to stress).
While waiting for the doctor, I continued to read the literature provided and make note of the posters and notices placed on the walls. One large poster illustrated the acupuncture points used in Traditional Chinese Medicine. [I have a friend who is an acupuncturist and her treatments have helped me tremendously in dealing with pain and stiffness.] However, no diplomas or certifications were prominently displayed in Dr. Berg's office.
One of the first things that the doctor discussed after introducing himself was the urine test which showed a pH level of 7.0 and elevated leukocyte level. I was told that my pH was completely neutral which needed to be addressed and that the elevated leukocyte level indicated a possible urinary tract infection. The first thing I asked was "what is a normal pH level for a regular person and then what is a normal pH level for someone who takes the medications I do?" It was at this point that the doctor looked down at my forms and replied, "Oh, you are taking a lot of medications. What are these for?"
The red flag began to rise.
I referred to the form where I had carefully listed each medical conditions including multiple sclerosis and rheumatoid arthritis. I also stated cheerfully that, yes, I had double-dipped in the autoimmune pot. Then the doctor showed me a graph which illustrated the results of the Heart Rate Variability test. Apparently, my heart did not show optimum strength and resiliency. The doctor explained it was like 'I had one foot on the gas pedal while the other foot was on the brake pedal.'
The doctor further explained that I likely had problems with my adrenals and thyroid. He encouraged me to attend the next seminar he was offering on Saturday morning in order to get the full amount of information I would need to complete the study. I agreed to attend. But I'll tell you now that if the advertisement had mentioned a Seminar, I would not have responded. Due to recent experience at unrelated seminars (1,2), I have become quite suspicious of such offerings.
At The Seminar
At the Seminar, Dr. Eric E. Berg discussed the influence of hormones on the storage of body fat as is discussed in his recently published book, "The 7 Principles of Fat Burning." To accompany the book, Dr. Berg has made available an online software program, called the "Fat Burning Tracker," which purports to track the hormonal influences of specific foods and activities. It was at the seminar that I first learned Dr. Berg is a chiropractor, a minor detail which had been glossed over until this point.
During the demonstration portion of the seminar, Dr. Berg illustrated a system of muscle-testing various points on the body to locate energy blockages which help to determine weakness in a correlating endocrine system. After further research, I have identified Dr. Berg's technique as Contact Reflex Analysis (CRA), a system of analysis using reflex points on the body and muscle testing which seems to be rooted in the theories of Applied Kinesiology. CRA is not widely accepted in conventional medicine as is evident in this article by Stephen Barrett, MD - "Contact Reflex Analysis is Nonsense."
Also during the seminar, I browsed the "7 Principles" book and noted that much of the material seems to have been taken from Guyton/Hall - "Textbook of Medical Physiology" and Faigin - "Natural Hormonal Enhancement". To promote and ensure the success of this latest book, Dr. Berg employed the services of Gilleard Market Research. I have to admit that the 'Fat Burning' site is very snazzy and presents an interesting approach to educate the user on the interactions of nutrition, hormones, and health.
The Health and Wellness Center and BRT
The Health and Wellness Center is owned and operated by Dr. Eric Berg, D.C. He is a Certified Doctor of Chiropractic by the Virginia and California Boards of Medicine. [California license expired in 1995.] Dr. Berg is the developer of the Body Restoration Technique. The Northern Virginia center is the main training and intern location for over 1,000 healthcare practitioners around the world. The practitioners working at The Health and Wellness Center have been hand-picked and have achieved master-level certification in the BRT technique. When a client comes to our office, we consult them and recommend the best method approach using foods, exercise and nutrition. Our policy is that we never take on a patient who we can't help.
Although Eric Berg does have a valid license to practice Chiropractic Medicine issued by the Virginia Department of Health Professions, its current expiration date is March 31, 2008. Dr. Berg has been under investigation by the State Board of Medicine regarding his unique techniques and has been instructed to "cease and desist the use of, and any and all advertising pertaining to, BRT, NAET, CRT, ACG" among additional requirements to keep his license.Here's a selection of techniques and certifications referenced in Berg bios:
- Certified - Doctor of Chiropractic
- Developer - Body Restoration Technique (removed)
- Certified - Contact Reflex Analysis
- Certified - Nambudripad's Allergy Elimination Technique
- Certified - Jaffe-Mellor Technique
- Certified - Acoustic Cardiograph
- Inventor - Digital Endocardiograph
- Inventor - Acoustic Heart Monitor
- Advisory Panel - The Health Sciences Institute
- Guest Article - The Natural Health Association
- Member - American Association for Health Freedom
- Member - The Endocrinology Society (no such org in US?)
- Member - The Endocrine Society (unconfirmed)
- Member - Price-Pottenger Nutrition Foundation
- Member - Citizens Commission on Human Rights
- Member - Association for Better Living and Education
- Associate - Clinical Electromedical Research Academy
Various Websites dedicated to the work of Dr. Eric Berg:
- http://www.drberghealthytips.com/ (removed)
- http://www.bodyrt.com/ (removed - 'under construction')
- http://www.berghealthytips.com/ (removed)
Here are various concerns expressed online by others regarding adjacent businesses headed Dr. Eric Berg and Karen Berg (his wife):
- Scientology involvement since 1995 - Eric Berg and Karen Berg
- Concern over BRT legality issues discussed on Chirotalk Forum (July-September 2004)
- Concern (no date) over possible connection between the Health & Wellness Center and the Scientology Mission in Alexandria, VA (removed)
- Concern in February 2005 over The Mission of Alexandria operating a sauna to perform purification rundowns. (removed) The suspicion was that the Health & Wellness Center was uniquely equiped to prep clients to partake in the purification rundown. [I do not know if this occurs. No mention of sauna treatments were presented during the seminar.]
- Concern in November 2005 over possible connection between Health & Wellness Center and the Scientology Mission in Alexandria, VA
First of all, I don't wish to get involved in a discussion regarding the teachings or techniques of Scientology or the practices and techniques of trained Chiropractors. However, I do see some validity and benefit to Acupuncture and Traditional Chinese Medicine and I have found huge relief in the unique deep-tissue massage and range-of-motion techniques of Thai Yoga Massage. Finally, I hope that all readers can agree that our choices of food and exercise affect our health and well-being.
However, if medical professionals and health insurance companies continue to avoid involvement with scientifically-sound integrative medicine treatment options, it is reasonable to think that more patient-CEOs will unwittingly seek the guidance of self-proclaimed 'experts' on any number of specialties and treatment modalities.
Regarding the dietary guidelines of the belly-fat study, I have proactively decided not to make drastic changes in my diet (such as drinking a cranberry juice/lemon juice/apple cider vinegar concoction) which may or may not put undue strain on my liver. As it is, my blood is monitored regularly to detect any potential problems with liver functions caused by pharmaceutical medications. I don't need to make things worse.