Personalized Lifestyle Medicine for Children
It is common sense that preventing a problem is preferable to solving it, and the medical establishment has always touted prevention. Traditional prevention however, has always been a one-size-fits-all proposition: What’s the best diet? How much should I exercise? What are the most important vitamins? In other words, what’s the healthiest lifestyle?
The biomedical revolution of the past several decades has revealed the answer: it depends.
What we’ve learned from genomics, epigenomics, nutritional science, toxicology, etc., is that one size does not fit all, and hence the need for Personalized Lifestyle Medicine.
Lifestyle has many components that will be discussed here and in future installments, but a good place to start is by asking at what age lifestyle becomes important. Middle age? Young Adulthood? Believe it or not, there is good evidence that your parents’ lifestyle affects your health even before you are conceived, so certainly lifestyle issues in utero and throughout childhood have a significant impact.
Some of our biological individuality has to do with our genetic material and the wide variety of gene versions called Single Nucleotide Polymorphisms that we carry with us from conception. They affect how our complex metabolism works and involve all our body systems throughout our life. In addition, there are gene modifiers, ‘on’ and ‘off’ switches called epigenetics that influence the expression of our genes. Environmental factors such as diet or toxins can have these epigenomic effects and profoundly affect gene expression at any age.
An example we see in children is the process of methylation. If there are polymorphisms present that compromise methylation (a process that depends on B12, folate and other nutrients), the child’s brain receptors and neurotransmitters are affected and the child may develop ADHD. If we give MethylB12 or Methylfolate to that child we can help to restore proper methylation, and at times reverse the symptoms of the ADHD. Epigenetically, toxins like mercury or lead can negatively affect the enzymes that make methylation function adequately and avoidance of these heavy metals might therefore be protective. (Some researchers and clinicians feel that an increase in such environmental toxins may be responsible for the marked increase in autism that we have seen in the last two to three decades).
Although we have advanced greatly in terms of our ability to characterize the human genome, we are still very much in the early stages of interpreting and understanding their clinical implications, and how the expression of these genes is influenced by environmental factors. Therefore it is essential to incorporate age-old tried and true data in our clinical decision making, such as detailed patient histories (including environmental exposures), family history, clinical experience, metabolic testing, etc. If we conclude that there is a vulnerability, we can reasonably recommend certain lifestyle changes or practices to help prevent potential problems. If there is a strong family history of allergy, for example, we would pay extra attention to balancing intestinal flora in infants and try to minimize exposure to antibiotics, both therapeutically and in food.
Of course, there are general recommendations that will likely benefit most children. Sugar/high fructose corn syrup and trans fats are bad, so avoidance is encouraged. Fruits and vegetables are good. Stress should be reduced. Environmental toxins such as pesticides and plasticizers are to be avoided. But whether to avoid gluten or dairy, whether to look for heavy metals, whether to restrict carbohydrates, whether to take this nutrient or that one – it’s questions like these that go to the heart of Personalized Lifestyle Medicine, and which for many years we’ve been asking at Bock Integrative Medicine as we strive to provide our patients with personalized/individualized evaluation and treatment programs.
For more information, you can check out our website: www.bockintegrative.com as well as
Dr. Bock’s latest book, Healing the New Childhood Epidemics: Autism, ADHD, Asthma and Allergies.
Our office can be contacted:
Bock Integrative Medicine
50 Old Farm Road
Red Hook, NY 12571