SBTI study: Multi–institutional Collaborative Clinical Trial to Examine Health Benefits of Integrative Lifestyle Practices at the Chopra Center for Wellbeing

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Self–Directed Biological Transformation Initiative (SBTI) study will use latest mobile health sensors and genomic/cellular/metabolomics biomarkers

Scientists and clinicians from seven research institutions have joined together for a first of a kind clinical trial on a whole systems approach to wellbeing. Such an in–depth clinically focused study is unique because previous research studies have typically examined the beneficial effects of individual wellbeing practices – such as meditation, yoga, or specific herbal preparations – few have taken anything like a whole systems approach which simultaneously includes a number of such practices to promote improved mind-body functioning.

The Chopra Center for Wellbeing has been in the forefront of integrating whole systems approaches such as Ayurveda, meditation, yoga, massage, herbal treatments, and nutrition into programs for improving health and wellbeing.

This new study pulls these strands together in the most comprehensive manner to date. By measuring the total effect of an intensive immersion into a whole systems program, the aim of the SBTI study is to see if the data will demonstrate a person’s connection to the healing process. The body’s healing system is still little understood as a whole, because of the complex inputs–thoughts, emotions, diet, stress, exercise, immune response, etc.––that affect whether we heal or not. The picture is further clouded when isolated findings overlap or contradict one another.

In the context of Ayurveda and most other traditional medicine, therapies and practices aren’t done in isolation. Instead of focusing on local symptoms, the diagnosis is systemic. Only now is Western medicine beginning to understand that a blanket condition like “stress” or “inflammation” connects many diverse disorders, including heart disease, cancer, and diabetes. A strong link has also been made to lowered immunity and aging.

The SBTI study will objectively examine the benefits of a whole systems approach in a controlled trial design. The resulting data will cover a broad range of biochemical, physiological, and psychosocial measurements. The intent of the study is not to examine the separate effects of the ‘active ingredients’ of the intervention, but rather assess the combined effects of the full suite of wellness practices.

The SBTI study will be being conducted during a weeklong intensive Ayurveda treatment program at the Chopra Center, located at the OMNI La Costa Resort in Carlsbad, CA. Potential study participants are randomized to join either the Ayurveda program or a seven–day stay at the resort without treatment, which serves as the control. Participants are evaluated four times: at home prior to arriving at the Center, immediately upon arrival, immediately following the treatment program, and one month later in a follow–up assessment. As shown in the table below, the contributing institutions are examining many crucial markers through sophisticated testing of RNA expression; telomerase activity (linked to the aging process), a variety of metabolites, peptides, and neurohormones (connected to metabolism, addictions, and mood changes as well as the messaging between brain and body), the microbiome (the enormous population of microorganisms on the skin and in the intestinal tract, and their collective genetic material), circulating protease activity, mobile cardiac functioning, balance of the autonomic nervous system and assessments of mental, emotional, and spiritual wellbeing.

It is anticipated that findings from the SBTI study will demonstrate the considerable cumulative value of taking a whole systems approach to health and wellbeing (an expectation bolstered by important studies cited below. (Source Dr Deepak Chopra)

Opening only the culprit vessel in acute heart attack no more recommended

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American College of Cardiology has announced that it is “withdrawing” one of its Choosing Wisely recommendations, following the announcement of the CVLPRIT results last month at the European Society of Cardiology 2014 Scientific Sessions.

CVLPRIT showed that patients undergoing primary PCI who had complete revascularization at the time of their index admission had lower rates of major adverse cardiac events at 12 months, as compared with patients who had only their “culprit” vessel treated.

Deaths were doubled in the patients who had only their infarct–related artery treated, as were rates of recurrent MI and rates of heart failure, although none of these were statistically significant, given the low patient numbers. Importantly, no difference in procedure-related adverse events was seen between groups.

Results from the CVLPRIT trial, as well as from last year’s Preventive Angioplasty in Myocardial Infarction (PRAMI) trial, warrant a rethink of this advice.

Promote heart healthy environments

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On World Heart Day 29th September 2014, pledge for heart–healthy environments, to reduce the burden of cardiovascular disease, which includes heart disease and stroke, the world’s number one killer. At least 80% of premature deaths from heart disease and stroke could be prevented by addressing risk factors such as tobacco use, harmful use of alcohol, salt intake, physical inactivity and raised blood pressure.

Too often, the onus for lifestyle changes is put on the individual; stop smoking, eating an unhealthy diet and not exercising. However, what is often forgotten is that many people don’t always have opportunity to make the right choice due to the confines of their home, work, school or community environments.

For example:

People who live in urban areas are often exposed to increased fast food outlets and advertising
In developing countries, billions of people face unsafe cooking environments, e.g. nearly 3 billion people cook food and heat their homes with traditional cookstoves or open fires, facing high exposure to smoke and fuels. This results in 4 million premature deaths every year
Unsafe outdoor spaces can lead to a more sedentary lifestyle; in urban areas, too few neighborhoods have good street lighting, continuous and connected sidewalks, and a variety of shops, services, parks, schools and workplaces within walking distance of homes
Health systems in many poorer countries have not kept pace with the explosion in rates of CVD and as such, people in more rural areas do not always have access to health services to advise them on heart health and access to the right medicines.

On this World Heart Day, all national and international leaders should make the ‘heart choice’ not the hard choice” and create an atmosphere, which is heart–friendly.

Initiatives

In Bogotá, every Sunday and on public holidays, the main streets are closed off to encourage people to be physically active. 10% of the population take part and are two times more likely to meet physical activity guidelines than those who don’t get involved
In New York City, the Department of Transport created pedestrian zones in Times Square along with other areas in New York. As a result, pedestrian volume increased by 11% and there was a 49% drop in vacant storefronts in Union Square
In Bangkok, an expressway called the Ploenchit Expressway was built to reduce traffic congestion. In the process of building the expressway, there were 623 acres of empty space.

The government invested in developing this space into community health centers, sports facilities and IT centers.
In Paris, the mayor announced the launch of a pilot programme to ban tobacco use in one of the City of Light’s parks. This is a significant step in creating smoke–free public spaces.

Let’s join the WHO ‘25 by 25’ goal of reducing premature mortality caused by CVD by at least 25% by the year 2025.

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