Tuesday, November 15, 2022

Early Detection: The Risk of Being "Too Young for a Mammogram"


 A major concern is the presence of breast cancer in underserved communities, including those TOO YOUNG FOR A MAMMOGRAM.  Whereby the medical community touts the recommended (and legal/billable status) of getting a mammo scan should be between 40-50, what happens to the many women who do not fit this age criteria?  How would they even know to get checked without the support of their clinicians or an alarm from family history?

Decades into the battle against breast cancer, clinicians and the public are much more educated about EARLY DETECTION, PREVENTION and the current protocols and modalities available to save lives.  Recent headlines on DENSE BREAST and the advancements in ULTRASOUND SCANNING supports a major part of this battle.

UNDERSERVED AGE FOR EARLY DETECTION

By Dr. Robert L. Bard and Joe Cappello of AreYouDense.org

According to Breastcancer.org, "Where mammography is available, ultrasound should be seen as a supplemental test for women with dense breasts who do not meet high-risk criteria for screening [with] MRI and for high-risk women with dense breasts who are unable to tolerate MRI... but if mammography isn’t available, then ultrasound seems to be a good alternative for breast cancer screening."

Doppler Sonography offers clinical accuracy and access
to breast imaging evaluation (www.breastcancernyc.com
)


A recent cohort study is underway under a partnership between Molloy College and AreYouDense.org  to publish new findings about low BMI patients and younger women about the presence of dense breast tissue.  This same review also covers the advantages of ultrasound use where mammography is not available.

Mammography is the current standard for breast cancer early detection for women 40 & older. Recent studies have shown nearly half of all women who get mammograms are found to have dense breasts, exposing this population to the risk that mammograms may miss potentially cancerous tumors concealed by dense breast tissue.  Dr. Cutter's initial concepts to target LOW BMI (bet 12-22% body fat) was personally inspired.  As an active TRIATHLETE, her own diagnosis sparked her survey and inquiry throughout the athletic community where she uncovered a significant trend that became the basis for this research. She wishes to target younger women, athletes and members of underserved communities. "Younger women may be more likely to have dense breasts... also I find athletes with LOWER BMI (body mass index) or those with  less body fat are more likely to have more dense breast tissue compared with women who are obese." (See complete feature article)


VIEWPOINT 
WHAT ABOUT IF YOU'RE TOO YOUNG FOR A MAMMOGRAM?   I went to my doctor for a lump I felt in my breast and she gave me a response that set off red flags: "don't worry about it". Being a researcher involved in breast density and breast cancer, I knew that I had to take action; I was fortunate enough to have my breast ultrasound training with Dr. Robert Bard (cancer imaging specialist, NYC) upcoming in the next week. Dr. Bard showed me how to use the ultrasound to help me find two benign tumors in my breasts, and it was there that he reported that I have dense breasts. Had I not taken action in getting screened at the young age of 22, I would have never known that I should be getting screened via ultrasound every 6 months (because having dense breasts puts me at a higher risk for breast cancer), nor would I have known that I had benign breast tumors. 

- ALEXANDRA FIEDERLEIN, 22
Cancer Researcher/ Graduate- Molloy Univ.



NEWS FROM THE FIELD 

Click to see NEWS
The DENSE BREAST TISSUE / CANCER CONNECTION is a topic that has finally achieved proper recognition in our community. Thanks to organizations like The 'ARE YOU DENSE?' Foundation, awareness of this health concern has now shed light to the risk to 40+% of the national women's population whereby more clinicians are now recognizing the need to state a patient's dense breast status.  Research crusaders like  Dr. Noelle Cutter and research associate Alexandra Fiederlein from Molloy University are underway the 2022 National Survey of Dense Breast Studies by bringing ultrasound access to underserved members of the women's community. 

In a recent episode of SPOTLIGHT ON AMERICA, Dr. Bard spoke as the clinical expert in the report "Millions of women have this breast cancer risk factors... why aren't they being informed?" -- TND REPORT/Spotlight on America is pressing to ensure women have access to a crucial health fact that could save their lives. According to the Centers for Disease Control and Prevention, 40% of women have dense breast tissue, which is a risk factor for cancer. The TND team first highlighted this issue in October 2021, and more than a year later, we expose how some women are still being left in the dark about their density, and federal health bodies are failing to make sure they’re informed.




2022 REVIEW ON WOMEN'S EARLY DETECTION STANDARDS 
Excerpt from the 2021 NYCRA Dense Breast Diagnostic Conference By: Dr. Roberta Kline

Breast cancer is still one of the most common cancers in women, and the leading cause of cancer mortality. While mammography is considered the standard imaging for early detection, it falls short for many – including those with dense breasts. Approximately 40% of women have dense breasts, which we now know is associated with an increased risk of breast cancer. On top of this increased risk, mammogram is less sensitive for early detection – up to 50% less for women with the highest breast density. [1] As a result many women are not diagnosed until they have a much later stage cancer – and a worse prognosis. [2]

The State of Connecticut passed legislation requiring notification of breast density in 2009, after having passed legislation requiring insurance coverage for ultrasound for dense breasts in 2005. As an ObGyn physician practicing in CT at the time, I remember the discussions with colleagues and patients around this issue although at the time there were no formal efforts to raise awareness or update guidelines from our national specialty organization, the American College of Obstetricians and Gynecologists (ACOG). 


PERSPECTIVE: PERSONAL FINDINGS BY A CLINICAL PROFESSIONAL
I was fortunate to have benefited personally from this effort when I had my first screening mammogram shortly after the law went into effect. The reading radiologist personally informed me of my high breast density immediately after the mammogram, and after recommending a breast ultrasound for further evaluation this was done right then and there. I walked away from my appointment feeling well informed, and any potential anxiety relieved by the prompt additional imaging and results. I also knew that I needed a different approach for my screenings going forward.

Between 2009 and 2019, 37 other states and D.C. passed legislation requiring notification of breast density, one of the last being my new home state of New Mexico. In 2019 a federal law was passed to require both clinician and patient reports contain plain language around the woman’s breast density, and to discuss with her provider. The FDA then created standard language that has now been implemented, requiring reporting on a woman’s individual breast density, and recommendation to discuss with her provider.
There is still much to be learned about what causes dense breasts and why women with dense breasts have an increased risk of breast cancer, and our ongoing study is one of many that are seeking to answer these questions at the molecular and genetic level. But the evidence that supplementing mammograms with other imaging modalities can increase the rate of early detection is substantial, and provides us with tools we can use right now to make a difference. [3,4]  Despite this progress, there are still significant hurdles in changing the standard of care. A recent experience with my routine breast cancer screening highlighted the ongoing challenges. When I had asked to schedule an ultrasound with my screening mammogram, I was informed that it was not done this way – I could only get a mammogram. After my mammogram, I had to wait to receive my letter in the mail approximately one week later to be able to take any additional steps. The interpretation included a description of breast density and recommended to discuss any additional care with my physician. 

When I called to schedule an ultrasound, I was told that since the radiologist did not recommend it in the report, I could not schedule it. I then had to speak with my primary care provider, educating her on dense breasts and why I needed an ultrasound. Luckily, she agreed to order one. While the radiology facility still questioned the order, eventually I was able to have this done. When the radiologist came in to discuss my results, she too was confused as to why I was having the ultrasound, and was not aware that this should be standard for women with dense breasts.

See 2022 Dense Breast Ultrasound Study
Fortunately all was fine, but had I not been a physician that was fully aware of this issue, I would very likely have had only a mammogram and walked away with a dangerously false sense of security. This experience highlighted for me how much still needed to be done more than 20 years after my first experience. Legislation is only part of the solution. Clinician education and public awareness are the keys to changing how the intention behind these laws gets translated into actual change in health care.

As I experienced, many clinicians are ill-informed about the nature of dense breasts, and options for adjunctive screening including ultrasound or MRI. This means that many of these reports end up being filed away with no further action being taken that could make a significant difference in early detection and saving lives.

EPILOGUE: CURRENT STANDARDS VS NEEDS
ACOG still officially does not recommend any further imaging for women with dense breasts on mammogram, despite the significant body of evidence suggesting that mammogram alone is insufficient and adjunctive imaging with ultrasound or MRI increases rate of early detection. [5] The U.S. Preventive Task Force [6]  does not recommend routine adjunctive imaging for screening women with dense breasts. This leaves many healthcare practitioners, from ObGyns to other primary care providers, unprepared to discuss this with their patients or provide sound recommendations. 

The American College of Radiologists, who also publishes the BIRADS standards for breast cancer screening, acknowledges awareness of breast density detection issues with mammography but stops short of recommending routine adjunctive imaging. Instead, they list ultrasound and MRI as “may be appropriate”. [7] We have enough evidence to know how to better serve women with dense breasts, and we can do better. Now we need to push for better education of all primary health care providers, including ObGyns, and continue to raise awareness for women around current knowledge and best practices. 



References
1) Gordon PB. The Impact of Dense Breasts on the Stage of Breast Cancer at Diagnosis: A Review and Options for Supplemental Screening. Curr Oncol. 2022 May 17;29(5):3595-3636.
2) Chiu, S.Y.H.; Duffy, S.; Yen, A.M.F.; Tab├ír, L.; Smith, R.A.; Chen, H.H. Effect of baseline breast density on breast cancer incidence, stage, mortality, and screening parameters: 25-Year follow-up of a Swedish mammographic screening. Cancer Epidemiol. Biomark. Prev. 2010, 19, 1219–1228
3) Harada-Shoji N, Suzuki A, Ishida T, Zheng YF, Narikawa-Shiono Y, Sato-Tadano A, Ohta R, Ohuchi N. Evaluation of Adjunctive Ultrasonography for Breast Cancer Detection Among Women Aged 40-49 Years With Varying Breast Density Undergoing Screening Mammography: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2021 Aug 2;4(8):e2121505
4) Mann, R.M., Athanasiou, A., Baltzer, P.A.T. et al. Breast cancer screening in women with extremely dense breasts recommendations of the European Society of Breast Imaging (EUSOBI). Eur Radiol 32, 4036–4045 (2022).
5) Management of Women With Dense Breasts Diagnosed by Mammography. ACOG Committee Opinion. CO Number 625 March 2015
6) https://uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening
7) American College of Radiology ACR Appropriateness Criteria® Supplemental Breast Cancer Screening Based on Breast Density. 2021

Copyright Notice: The materials provided on this website/web-based article are copyrighted and the intellectual property of the publishers/producers (The NY Cancer Resource Alliance/IntermediaWorx inc. and The AngioFoundation). It is provided publicly strictly for informational purposes within non-commercial use and not for purposes of resale, distribution, public display or performance. Unless otherwise indicated on this web based page, sharing, re-posting, re-publishing of this work is strictly prohibited without due permission from the publishers.  Also, certain content may be licensed from third-parties. The licenses for some of this Content may contain additional terms. When such Content licenses contain additional terms, we will make these terms available to you on those pages (which his incorporated herein by reference).The publishers/producers of this site and its contents such as videos, graphics, text, and other materials published are not intended to be a substitute for professional medical advice, diagnosis, or treatment. For any questions you may have regarding a medical condition, please always seek the advice of your physician or a qualified health provider. Do not postpone or disregard any professional medical advice over something you may have seen or read on this website. If you think you may have a medical emergency, call your doctor or 9-1-1 immediately.  This website does not support, endorse or recommend any specific products, tests, physicians, procedures, treatment opinions or other information that may be mentioned on this site. Referencing any content or information seen or published in this website or shared by other visitors of this website is solely at your own risk. The publishers/producers of this Internet web site reserves the right, at its sole discretion, to modify, disable access to, or discontinue, temporarily or permanently, all or any part of this Internet web site or any information contained thereon without liability or notice to you.

Tuesday, October 25, 2022

GET TO KNOW YOUR ANXIETY AND STRESS

HEALING, STRESS AND THE PARASYMPATHETIC SYSTEM (part 1)

Written by: Roberta Kline, MD 

Analyzing STRESS & ANXIETY from a holistic point of view means identifying the body’s interconnected systems (ie. circulatory, cardiovascular, nervous, lymphatic, endocrine etc.) and its many touch points for stimulation.   This analysis should also offer a comprehensive breakdown of the body's HEALING capacity- which includes our hormones, digestive system, immune system, brain, heart-- all the way down to our cells and mitochondria.  

Stress is part of life, and comes in many forms including physical, emotional, mental and environmental. Foods we eat, unhealthy relationships, difficulties at work, toxins in our environment, even poor posture or lack of sunshine can all create stress on our bodies. But when stress is catastrophic or becomes chronic, it creates imbalances in this functioning that are much more likely to promote disease while at the same time preventing healing from taking place. [1]

With people under record levels of chronic stress, it is no wonder we have an epidemic of people suffering from all sorts of health issues and chronic diseases. Heart disease, diabetes, obesity, pain, anxiety, depression, infertility, cancer, autoimmune diseases such as arthritis, neurodegenerative diseases such as Alzheimer’s …. These are just some of the many health conditions that have been linked to diet and lifestyle including chronic stress. [2, 3] But how does this work? And is meditation the answer to reversing this trend? Science is revealing some interesting clues.


THE NERVOUS SYSTEM
One big connection is our nervous system. Our nervous system is our superconductor network of information exchange throughout our bodies, and consists of two main parts. The first is the central nervous system (CNS). As it sounds, it’s our command center where all data comes to be processed, and is made up of the brain, spinal cord, and nerves. The second is called the peripheral nervous system (PNS) and it connects every part of our body to our CNS through individual nerve cells called neurons and clusters of neurons known as ganglia.

The PNS is further divided into the Somatic Nervous System, also known as the voluntary nervous system, and the Autonomic Nervous System. The Autonomic Nervous System (ANS) manages all bodily functions that are not under conscious control. This includes heart rate, blood pressure, digestion, respiration, cellular activity, immune system, hormones, brain function, sexual function, and even body temperature.

The ANS is further divided into two parts: the Sympathetic Nervous System (SNS), which regulates our “fight or flight” response, and the Parasympathetic Nervous System (PNS), which controls our “rest and digest” response. They work closely together in a complex dance, maintaining our bodily functions and ensuring our survival every second of our lives.

Many health issues, including most chronic diseases such as heart disease, autoimmune disease, diabetes, depression and anxiety, and cancer, are related to an imbalance of our autonomic nervous system. Most typically, it is too much of the “fight or flight” and not enough of the “rest and digest” that leads us into this imbalance. [4]

See complete feature by Dr. Roberta Kline




HOW THERAPISTS DIAGNOSE MENTAL HEALTH ISSUES
By:  Jessica Connell, LCSW






An Excerpt from Diane Calabrese's latest book:
"Meditations for the Mind-Body-Spirit"

FOREWORD:
In a world where ANXIETY & STRESS have become an expected ingredient to the bustling rat-race of our daily race, there remains countless signs from the medical community of a dire need for self-management in this department.  More than a comical quip, STRESS is (by all definitions) a KILLER -- and unbridled ANXIETY can spiral into physiological disorders causing rapid heart rate, high blood pressure and heart disease - elevating the risk of coronary events. Rooted from a lifestyle imbalances in our emotional state calls us to address an upgrade in the mind-body connection. 

GUIDED MEDITATIONS are a way to let go of your worries for the moment and bring you back to your true, authentic self. It helps re-align the chakras of your body to their natural state of vibration, –where you can live more fully, love more abundantly, and react in a peaceful state of mind. 

Your mind, body, and spirit are the essential parts of you. You are God’s precious gift to the world and there is nothing more beautiful than a soul in the state of peace. Guided meditation is one of many holistic healing modalities that has many benefits. The practice of guided meditation is dated back to the beginning of time, we all need to quiet the mind, to let go of all the chatter of everyday life, –to recharge, replenish and rejuvenate the soul. 

Meditation can be implemented for long and short periods of time. We live in a world that is constantly cluttering our lives. We need to take time out for ourselves. When we do that, –we feel more relaxed. We can give more of ourselves and to others in positive ways because we are refreshed. Meditation lifts our spirit to a higher level of vibration so that we can handle life’s troubles and triumphs to our best capability.  While working at the Veteran’s Administration Medical Center in Northport, Long Island, –I would always include guided meditations as part of my practice with my patients. Many patients felt the soothing music and aromatherapy used in conjunction with the guided meditations made the experience even more pleasant, so it’s important to take note of what works best for you.

Meditation is a practice known to man since the beginning of time. The history of meditation is rooted back in religion and spiritual practice; however, as cultures and societies changed, –so did its practice. The English word “meditation” comes from meditatum, a Latin word meaning to “ponder.” When we ponder, –we reflect, we think. But instead of thinking in haste, –we think with clarity. We let go of toxic thoughts, –calming the mind, body, and soul to lead a more peaceful and happy life. There are many benefits to prayer, meditation, and guided imaginary. 

Meditation has proven benefits to reduce anxiety and depression; fear and apprehension; stress and tension; calming your mind and nerves; and improving your physical health. There are various forms of meditation and differences in how people respond to meditation. Each time you practice meditation, –you are generally, –able to let go more easily, and may go into a deeper meditation. You become light itself. Meditation increases your concentration and ability to stay focused.  Ultimately, it increases your wisdom and intuition. Meditating in the morning provides you with inspirational energy for the day, –and meditating in the evening encourages a restful sleep.


Meet our newest contributor:

Diane Calabrese, MS, CTRS is the author of Meditations for the Mind-Body-Spirit and is an adjunct professor for Florida International University. Diane was practicing as a recreational therapist for 30 years. She holds a master’s degree in Healthcare Policy and Management Sciences and a bachelor’s degree in Recreational Therapy. In addition, she has worked in a variety of healthcare settings. Diane's passion led her to continue her education in various holistic healing modalities.   



RECHARGING FOR CAREGIVERS
By: Dr. Leslie Valle & the Prevention101 Editorial Team

During the Covid-19 surge, interviews with emergency medical professionals showed dramatic cases of ICU and ER responders exposed to major signs of advanced fatigue and risk of burnout.  This significantly raised major risks to their work performance where lives are to be affected, including theirs.  Over time, double and triple shifts resulted in "a different type of pandemic" on a national scale- where this level of exhaustion and overwhelm.  

Where a leave of absence, a vacation or regular rest is not an immediate option, we can start with addressing BRAIN HEALTH AND MENTAL HEALTH.  Modern meditation solutions (like BrainTap®, Loving Meditations® and other such technologies) are now available for exactly this emergent case as a portable personal "Rescue" dose. By tap ping the mind/body connection into a Vital Re-charge mode, we can induce a "Refresh- Revitalize-Renew" condition.  As with conventional meditation, bringing you into a regenerative meditative state offers that level of rest, clears the mind for renewed focus and new energy to continue with the 'battle' at hand. 



2022 TRENDING INTEREST IN BRAIN HEALTH
By: David Dachinger & Joshua Schueller

Within the recent decade, a higher level of focus on brain health has been a trending topic in headlines throughout medical community news.  Public concerns about Alzheimer’s, Dementia, MS, ALS and other neurodegenerative diseases has driven advanced research in their diagnostics, therapeutics and prevention. According to Dr. Jay Lombard, “One of the most exciting opportunities in neuroscience research today is the use of strategies that protect the brain which may potentially prevent, delay or inhibit the progression of neurodegenerative diseases… this opportunity rests on our ability for early diagnosis. Research has shown that the likelihood of success for a given treatment-whether lifestyle changes or pharmacological approaches- is highly dependent upon early intervention, before the disease process has become too severe and potentially irreversible.” [1] 

 In addition, growing reports on Chronic Traumatic Encephalopathy/CTE (identified from head concussions) has prompted significant attention to this progressive brain condition.  According to the National Health Service (UK), this disorder “is thought to be caused by repeated blows to the head and repeated episodes of concussion. It's particularly associated with contact sports, such as boxing or American football. Most of the available studies are based on ex-athletes”. [2]

More concerns of brain function and performance is widely seen in the current pandemic and post-covid infection sequelae cases, where over 50 prevailing symptoms and disorders (known as LONG HAUL) are now under global review. Clinical researchers state post-acute COVID—affects a multitude of organ systems- including neuropsychiatric issues like BRAIN FOG, a form of cognitive impairment. This may be linked to a wide range of pathologies such as anxiety and depression, post-traumatic stress disorder (PTSD) and recurring headaches and migraines. [3] In a recent meta-analysis study on long term effects of covid-19, Dr. Sonia Villapol (Assistant Professor of Neurosurgery at the Center for Neuroregeneration in the Houston Methodist Research Institute & Asst. Professor at Weill Cornell Medicine) recorded significant long haul cases pertaining to brain health and functions including 44% headaches, 27% attention disorders, 13% anxiety, 12% depression. [4]




ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group) is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She currently serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. 

LESLIE VALLE, MD - is the founder of Biomed Life/ Santa Barbara Longevity Center. After medical school, Dr. Valle focused on managing chronic disease starting with its links to poor nutrition and then introducing them into the world of energy frequencies.  She explores and includes non-invasive modalities such as: frequency therapies (including biofeedback), PEMF, proper detoxification, nutritional guidance and binaural beats as needed.

JOSH T. SCHUELLER is a licensed Physical Therapist supporting and treating chronic pain and disorders with non-invasive, treatment solutions. He is the current VP of Clinical Operations and Business Development at AxioBionics LLC. and is formerly the Clinical Director for Orthopedic Physical Therapy Clinics (Rockford, MI).  He has over 20+ years experience in the treatment of neurological conditions such as Spinal Cord Injury, Traumatic Brain Injury, CVA, Cerebral Palsy etc.

Lt. DAVID DACHINGER (Ret) - is a retired Fire Lieutenant with over 21 years as a leader in emergency services. He is also a Stage IV cancer survivor. He wrote cancer prevention policies for the Ridgefield CT Fire Department, and introduced physical fitness wellness initiatives. David hosts the video podcast “Responder Resilience”, which is dedicated to improving the mental and physical well-being of police, fire, EMS, and dispatch personnel. 




Copyright Notice: The materials provided on this website/web-based article are copyrighted and the intellectual property of the publishers/producers (The NY Cancer Resource Alliance/IntermediaWorx inc. and The AngioFoundation). It is provided publicly strictly for informational purposes within non-commercial use and not for purposes of resale, distribution, public display or performance. Unless otherwise indicated on this web based page, sharing, re-posting, re-publishing of this work is strictly prohibited without due permission from the publishers.  Also, certain content may be licensed from third-parties. The licenses for some of this Content may contain additional terms. When such Content licenses contain additional terms, we will make these terms available to you on those pages (which his incorporated herein by reference).The publishers/producers of this site and its contents such as videos, graphics, text, and other materials published are not intended to be a substitute for professional medical advice, diagnosis, or treatment. For any questions you may have regarding a medical condition, please always seek the advice of your physician or a qualified health provider. Do not postpone or disregard any professional medical advice over something you may have seen or read on this website. If you think you may have a medical emergency, call your doctor or 9-1-1 immediately.  This website does not support, endorse or recommend any specific products, tests, physicians, procedures, treatment opinions or other information that may be mentioned on this site. Referencing any content or information seen or published in this website or shared by other visitors of this website is solely at your own risk. The publishers/producers of this Internet web site reserves the right, at its sole discretion, to modify, disable access to, or discontinue, temporarily or permanently, all or any part of this Internet web site or any information contained thereon without liability or notice to you.


Tuesday, October 18, 2022

HEALING, STRESS AND THE PARASYMPATHETIC SYSTEM (part 1)

Written by: Roberta Kline, MD

Analyzing STRESS & ANXIETY from a holistic point of view means identifying the body’s interconnected systems (ie. circulatory, cardiovascular, nervous, lymphatic, endocrine etc.) and its many touch points for stimulation.   This analysis should also offer a comprehensive breakdown of the body's HEALING capacity- which includes our hormones, digestive system, immune system, brain, heart-- all the way down to our cells and mitochondria.  

Stress is part of life, and comes in many forms including physical, emotional, mental and environmental. Foods we eat, unhealthy relationships, difficulties at work, toxins in our environment, even poor posture or lack of sunshine can all create stress on our bodies. But when stress is catastrophic or becomes chronic, it creates imbalances in this functioning that are much more likely to promote disease while at the same time preventing healing from taking place. [1]

With people under record levels of chronic stress, it is no wonder we have an epidemic of people suffering from all sorts of health issues and chronic diseases. Heart disease, diabetes, obesity, pain, anxiety, depression, infertility, cancer, autoimmune diseases such as arthritis, neurodegenerative diseases such as Alzheimer’s …. These are just some of the many health conditions that have been linked to diet and lifestyle including chronic stress. [2, 3]

But how does this work? And is meditation the answer to reversing this trend? Science is revealing some interesting clues.


THE NERVOUS SYSTEM
One big connection is our nervous system. Our nervous system is our superconductor network of information exchange throughout our bodies, and consists of two main parts. The first is the central nervous system (CNS). As it sounds, it’s our command center where all data comes to be processed, and is made up of the brain, spinal cord, and nerves. The second is called the peripheral nervous system (PNS) and it connects every part of our body to our CNS through individual nerve cells called neurons and clusters of neurons known as ganglia.

The PNS is further divided into the Somatic Nervous System, also known as the voluntary nervous system, and the Autonomic Nervous System. The Autonomic Nervous System (ANS) manages all bodily functions that are not under conscious control. This includes heart rate, blood pressure, digestion, respiration, cellular activity, immune system, hormones, brain function, sexual function, and even body temperature.

The ANS is further divided into two parts: the Sympathetic Nervous System (SNS), which regulates our “fight or flight” response, and the Parasympathetic Nervous System (PNS), which controls our “rest and digest” response. They work closely together in a complex dance, maintaining our bodily functions and ensuring our survival every second of our lives.

Many health issues, including most chronic diseases such as heart disease, autoimmune disease, diabetes, depression and anxiety, and cancer, are related to an imbalance of our autonomic nervous system. Most typically, it is too much of the “fight or flight” and not enough of the “rest and digest” that leads us into this imbalance. [4]


FLIGHT OR FLIGHT
The Sympathetic Nervous System is located in the CNS, and in the spinal nerves from T1 (the thoracic region) down to L3 (the lumbar region) out to the neurons in the regions of the body supplied by these nerves. This sympathetic response is designed to keep us safe in the face of immediate danger. It signals the brain to turn up the volume on any physiological function crucial to staying to fight or running away from the source of the danger. Catecholamines such as epinephrine (adrenaline), norepinephrine (noradrenaline) and dopamine are released and a cascade of events happens rapidly – before we are even consciously aware that there is a threat. These include:

Blood flow diverted to the heart, lungs and skeletal muscle

Increased heart rate, blood pressure and respiratory rate

Enlargement of bronchioles (in lungs)

Dilation of pupils

Rapid conversion of glycogen to glucose for fuel

Activation of immune system

All other functions, including digestion, urination, higher level thinking, even sexual function and cellular repair, are temporarily turned off, so that all of our energy and resources go only toward ensuring our immediate survival. If the threat goes on for a longer period of time, a secondary system called the HPA (Hypothalamic – Pituitary – Adrenal) Axis takes over and relies on elevated cortisol and other hormonal changes to continue the high alert state.

But our bodies are not designed to be in this activated high-alert state for long periods of time. Once the immediate threat is gone, we are supposed to go back to our normal state of relaxation. This is the job of the Parasympathetic Nervous System.



REST AND DIGEST

The Parasympathetic Nervous System (PSNS) is located in the brain stem, includes nerves to the eyes and face, vagus and 10th cranial nerves, and sacral nerves (S2-S4). Regulated in large part by the vagus nerve (75%), it impacts a vast array of crucial bodily functions. When the parasympathetic response is triggered, it counteracts the fight or flight response primarily through release of acetylcholine.

Parasympathetic activation results in production of tears, saliva, and constriction of the pupils; lower and more variable heart rate, lower blood pressure and respiratory rate. It enables creative and critical thinking, normal kidney function and urination, improves immune function, enables sleep, sexual arousal and replenishment of fuel stores in organs; plus everything involved in digesting and utilizing our food including elimination and insulin production. Even mood and social bonding and connection are linked. 


HOW STRESS IMPACTS HEALTH AND HEALING
Healing requires coordination of a complex array of biological functional and systems. Research is rapidly expanding our understanding of the importance of the parasympathetic response, and how meditation helps to restore balance. While this impacts every biological system, here are some key areas:

  Digestion
Nutrients must be properly digested to extract them from our food and into our cells, where they are critical to every function our bodies must carry out. From vitamins and minerals that are needed in every biochemical reaction, to energy production in our mitochondria, to building blocks of our proteins that form our enzymes, neurotransmitters, hormones, even our DNA - all of our cells need these basic materials to function. Stress shuts down our digestion, and if it goes on long enough our cells become depleted of the very nutrients needed to function and repair. 

  Immunity
Approximately 90% of our immune system resides in our gastrointestinal tract. While it is needed to defend us against invaders such as bacteria and viruses, it can also go awry if unchecked. This “runaway” inflammation is linked to most chronic diseases, and paradoxically also reduces the ability to respond to infections. Our immune system has other functions, including being a cleaning crew. It removes debris left over from battling invaders. It also removes our own dead or badly damaged cells, and signals new and healthy ones to replace them. Stress results in an imbalanced immune system, making us vulnerable to infections as well as chronic disease.

  Mitochondria
These tiny structures exist within every cell in the body, and as the “power plants” of the cell they are responsible for producing all of the energy needed for every single function. This energy is produced as ATP and to make it requires key nutrients from food to be digested and absorbed from the gut. But producing this energy also creates toxic molecules, which are neutralized by antioxidants which also come from our diet. If the demand for energy is too great for too long, the mitochondria – and its cell – become damaged. Without healthy mitochondria, cells become damaged, dysfunctional and even die.


  Brain
The brain normally utilizes about 20% of our energy supplies, primarily in the form of glucose or ketones. This requires good digestion and healthy mitochondria to keep the brain supplied with fuel to function. 

  Acetylcholine is a major neuro-transmitter in the brain and in nerve endings through the peripheral nervous system; it is also anti-inflammatory. It is made in the mitochondria using some of the same ingredients needed for ATP production. 

Serotonin, a major neurotransmitter impacting mood, is mostly produced in the gut. When the stress response is prolonged, this depletes the brain’s capacity for creative and critical thinking and mood regulation, often further impairing the ability to deal with stress.



MEDITATION AND HEALTH

While meditation has been practiced in various forms for centuries, and has long been associated with many parameters of improved health and well-being, science is only recently starting to understand the mechanisms by which it works. Studies are demonstrating the positive impact of meditation practices on various disease conditions, and the potential power for it to change the trajectory of this epidemic of chronic disease. Research findings on HOW it works are not all consistent though, as ways of meditating can be quite varied and this seems to impact the results. However, some common threads are emerging; two main mechanisms are outlined below.

  Default Mode Network
One mechanism by which meditation works is by altering connectivity in the brain – the so-called Default Mode Network, or DMN. This is a network of brain regions that is active when the brain is restful but awake. Meditation seems to decrease this DMN activity, leading to increased cortical connectivity [5] - in other words, there is activity connecting areas of the brain that aren’t normally part of this network that enables us to take a different, more detached perspective on things in our life. When we aren’t so attached to events, the sympathetic response is less likely to be triggered, or if it is triggered it is to a lower extent that is easier to recover from.

  Vagal Nerve
Meditation also activates the parasympathetic response, in large part through the vagal nerve. This not only impacts heart rate and other vascular parameters, it also connects our gastrointestinal tract to our brain. There is now a growing body of evidence that this bidirectional communication through the “brain-gut axis” is a complex system that is key to our health, and when it is out of balance is linked to many health issues. [6]

Meditation has been shown to increase vagal nerve activity, or tone, and restore normal functioning of these many systems including digestion, immune response, and brain neuroplasticity/resilience. [6] It is thought that one way this occurs is through deep breathing, although there may be other mechanisms in play.  As we learn more about how meditation works and how it influences our biology, we can develop more targeted and personalized approaches to maximize its potential – while making it easy and accessible for people to integrate into their daily lives.


EPILOGUE

In a recent MeedTech Review of a meditation and brain optimizing device called BrainTap®,  Dr. Kline and her colleagues took on the task of assessing its ‘active ingredients’- binaural beats, isochronic tones, holographic music and blue/red light. (see complete tech review) It is found that these neurosensory applications have had a long history in other devices also supporting the science and wellness communities for their reactive properties.  Having collected the vast majority of user testimonials online, and clinical reports from fellow team mate, Dr. Leslie Valle (Santa Barbara, CA) who had already spent the better part of 3 years with the device on her patients, these reviews added greatly to our peace of mind about consumer safety.  

Academically, the appeal in assessing this specific product is partly due to the diverse and multiple points of wellness that the device was designed to target.  A wide range of brain and mental health-related specialists alike may truly enjoy conducting their own independent case study of this device, each using their specific level of science to assess its array of claimed benefits.  Areas like the parasympathetic nervous system, brain optimizing and stress & anxiety are just some of the key points of interest worth exploring.  If the device in fact aligns and supports Dr. Kline’s multi-layered physiological roadmap to wellness and the user’s reaction(s) in the meditation state, a fair and comprehensive tech review of this device should be best achieved under multiple streams of evaluators.  Reporting on its assessed benefits would then be a matter of the collective team trading notes for all areas of common ground.


ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group) is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://robertaklinemd.com/


References:

(1) Furman D et al. Chronic inflammation in the etiology of disease across the life span. Nat Med 25, 1822–1832 (2019).

(2) Cohen S et al. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. PNAS April 2, 2012: 109 (16) 5995-5999

(3) Vancampfort D et al. Perceived Stress and Its Relationship With Chronic Medical Conditions and Multimorbidity Among 229,293 Community-Dwelling Adults in 44 Low- and Middle-Income Countries. American Journal of Epidemiology, Volume 186, Issue 8, 15 October 2017, Pages 979–989

(4) Agnese Mariotti. The effects of chronic stress on health: new insights into the molecular mechanisms of brain–body communication. Future Sci OA. 2015 Nov; 1(3): FSO23.

(5) Jerath et al Dynamic change of awareness during meditation techniques: neural and physiological correlates. Front. Hum. Neurosci., 17 September 2012 Sec. Cognitive Neuroscience

(6) Breit et al Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders. Front. Psychiatry, 13 March 2018


Additional Resources:

Jacob Tindle; Prasanna Tadi. Neuroanatomy, Parasympathetic Nervous System. StatPearls Publishing Jan 2022

The Neuroscience of Meditation. Understanding Individual Differences. Academic Press 2020




Disclaimer: MEDTECH REVIEWS* is a non-commercial user review of health-related technologies and is not intended as a marketing program for any device(s) featured in this video for evaluation. This presentation is for informational use only and does not offer any direct medical claims whatsoever. Statements from all speakers herein are expressing their own unscripted views that do not reflect those of our producers.  Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment.

Copyright Notice: The materials provided on this website/web-based article are copyrighted and the intellectual property of the publishers/producers (The NY Cancer Resource Alliance/IntermediaWorx inc. and The AngioFoundation). It is provided publicly strictly for informational purposes within non-commercial use and not for purposes of resale, distribution, public display or performance. Unless otherwise indicated on this web based page, sharing, re-posting, re-publishing of this work is strictly prohibited without due permission from the publishers.  Also, certain content may be licensed from third-parties. The licenses for some of this Content may contain additional terms. When such Content licenses contain additional terms, we will make these terms available to you on those pages (which his incorporated herein by reference).The publishers/producers of this site and its contents such as videos, graphics, text, and other materials published are not intended to be a substitute for professional medical advice, diagnosis, or treatment. For any questions you may have regarding a medical condition, please always seek the advice of your physician or a qualified health provider. Do not postpone or disregard any professional medical advice over something you may have seen or read on this website. If you think you may have a medical emergency, call your doctor or 9-1-1 immediately.  This website does not support, endorse or recommend any specific products, tests, physicians, procedures, treatment opinions or other information that may be mentioned on this site. Referencing any content or information seen or published in this website or shared by other visitors of this website is solely at your own risk. The publishers/producers of this Internet web site reserves the right, at its sole discretion, to modify, disable access to, or discontinue, temporarily or permanently, all or any part of this Internet web site or any information contained thereon without liability or notice to you.