Navigenics is pleased to announce a new relationship with a national network of physicians who practice proactive, personalized medicine. Through the collaboration, the Navigenics genetic testing service will be made available to their patients, who number more than 100,000 nationwide. I’d like to share some of the information about this collaboration, as described in a news release issued today:

National Physician Group MDVIP Partners with Navigenics to Provide Personal Genetic Tests for Preventive Medicine Practice

Boca Raton, FL and Redwood Shores, CA – December 8 2008 – MDVIP, Inc., a leading national network of physicians dedicated to preventive and personalized healthcare, and Navigenics, Inc., a leading personal genomics testing company, today announced a first of its kind collaborative effort to integrate genomic-based preventive healthcare in physician offices. Through this initiative, Navigenics’ genomic testing service will be available to MDVIP affiliated physicians to help patients understand their genetic risk factors for disease and work with their doctors to develop individualized prevention plans.

Navigenics will provide MDVIP patients and their affiliated physicians with insight into their personal genetic predisposition for developing certain medical conditions where primary or secondary prevention could improve health outcomes. The Navigenics test will identify individuals’ genetic markers for developing such conditions as type 2 diabetes, cancer, heart attack, and celiac disease. Working with their personal MDVIP physician and Navigenics’ board-certified Genetic Counselors, individuals can chart and implement a personalized wellness course to help decrease their overall risk, delay disease onset or prevent it altogether.

“We have for many years been closely watching the field of genomic testing evolve into a tool that can enhance and inform the practice of preventive medicine,” said Edward Goldman, M.D., CEO of MDVIP. “We believe that Navigenics’ preventive genomics service has the potential to be an innovation that could significantly enhance patient care.”

“MDVIP physicians are national leaders in improving patients’ lives through leading-edge preventive medicine,” said Vance Vanier, M.D., Chief Medical Officer of Navigenics. “By thoughtfully incorporating genomic testing into their daily practice, these doctors will help to define the standards in which preventive genomic medicine will be integrated into patient care for decades to come.”

MDVIP and Navigenics spent six months studying the physician and patient experience of integrating preventive genomics in over forty clinical encounters. “The results were impressive,” said Dr. Goldman. “The patients overwhelmingly found the experience positive, they felt empowered rather than anxious, and they indicated a desire to change their lifestyles and more productively work with their physicians. We think there is tremendous value in bringing Navigenics’ responsible approach to incorporating this technology into patient care.”

Through this relationship, Navigenics’ genomic test will be offered as a service through many MDVIP practices. MDVIP consists of 280 primary care physicians who serve more than 100,000 patients nationwide. Interested patients will first learn more about the testing process in consultation with their personal physician and a board-certified genetic counselor. After providing a saliva sample, their DNA will be extracted in order to scan their genome and develop a personalized risk assessment.

“In my practice, patients are increasingly asking for more information about preventing disease, including what their genes might say about their personal risk factors,” said Dr. Andre Sanschagrin who participated in MDVIP’s pilot study. “The tools included in Navigenics’ service help me provide greater insight into what specific risks my patients may face, and help strengthen the physician-patient relationship as we work together to find ways to mitigate those risks. It really gives you a glimpse of how you can pull the future of medicine closer to today.”

ABOUT NAVIGENICS
Navigenics, Inc. is a privately held company based in Redwood Shores, Calif. The company was founded by David Agus, M.D. and Dietrich Stephan, Ph.D., with the goal of improving health outcomes in individuals across the population. Navigenics educates and empowers customers with knowledge of their genetic predispositions, and then motivates them to act on the information to prevent the onset of disease, achieve earlier diagnosis, appropriately manage disease, or otherwise lessen its impact. Navigenics’ lead investors are Kleiner Perkins Caufield and Byers, Sequoia Capital and MDV-Mohr Davidow Ventures. More information can be found at http://www.navigenics.com.

ABOUT MDVIP
MDVIP, Inc. is a privately-held firm, founded in 2000 and headquartered in Boca Raton, Florida. It is a national network of physicians, located in 25 States and the District of Columbia, who practice proactive, preventive and personalized healthcare, not just the detection and treatment of disease. With prevention as the cornerstone of its program, MDVIP has proven that it’s carefully chosen affiliated physicians provide exceptional care and achieve exceptional outcomes. These outcomes include lower hospitalization rates. For more information, go to http://www.mdvip.com.

“All natural sweetener.”

“Zero calories.”

Artificial sweeteners have been billed as the perfect alternative to sugar – a way for weight-conscious adults to have their cake and eat it, too. Yet more and more, a modicum of restraint is certainly advised when reaching for those packets of aspartame or sucralose.

While it’s true that sugar alternatives are much sweeter than table sugar, requiring smaller amounts to achieve the same level of sweetness, they won’t necessarily help you lose weight and keep it off. Simply taking the sugar out of a slab of chocolate cake doesn’t miraculously transform it into a low-calorie, high-nutrient food. At the end of the day, it’s still a slab of chocolate cake, with calories from flour, shortening, eggs, and other ingredients like nuts. So if you eat too much of it, your body will be the worse off from the encounter, regardless of which sweetener is used.

In fact, a growing body of evidence suggests that, when compared with sugar, no-calorie sweeteners may actually make it harder for people to control their body weight.

In one recent study on lab rats conducted by Purdue University researchers, rodents given yogurt sweetened with zero-calorie saccharin ended up consuming more food (and therefore, more calories) than rats given sugar-sweetened yogurt. They gained more weight, put on a higher level of body fat and had no natural sense that they should cut back on their eating.

“The data clearly indicate that consuming a food sweetened with no-calorie saccharin can lead to greater body-weight gain and adiposity than would consuming the same food sweetened with a higher-calorie sugar,” the study authors said.

Of course, rats aren’t people. But human studies have suggested there is a link between increasing obesity rates and our increasing consumption of diet soda.

Artificial sweeteners, scientists say, actually appear to carry a bitter paradox , with the intense sweeteners potentially serving to increase a person’s craving for sweet foods, promoting overeating. This is probably not what you expected when you put your money in the vending machine and thought you were making a “healthier” choice.

As a practicing physician for 30 years, I always reminded my patients that a teaspoon of sugar is only 15 calories—though a cup is 770. So, when consumed in moderation, sugar really isn’t the diet disaster it is made out to be. A teaspoon of sugar in an occasional cup of coffee, for instance, is not going to tip you – or the scales – over the edge; and it may be healthier in the end than an artificial sweetener.  Diabetics, whose condition makes them sensitive to sugar, need to discuss the use of artificial sweeteners versus sugar with their physicians. They have issues that go beyond weight control when it comes to sugar. But the American Diabetes Association makes note of an interesting point: “Research studies show that, gram for gram, sugars, like table sugar, do not raise blood glucose any more quickly than do other carbohydrates, like potatoes, rice or pasta. “

if you’re really concerned about your weight, skip the sweets altogether the next time your stomach is grumbling. Opting for a protein-rich snack, such as a slice of low-fat cheese, will curb your appetite longer and better.

If you’ve been blessed with genes that help you look good in your jeans, lucky you.

But you haven’t escaped the need to exercise.

Sure, being able to eat all you want without getting fat might seem like a blessing. Unlimited ice cream, limited time on the treadmill – what could sound better?  But studies clearly have shown that weight is not the best measurement of health. And if you’re physically inactive you aren’t doing yourself any favors, no matter what size you are.

Case in point: Recent research found that about one in four slim people had two cardiovascular risk factors, such as high blood pressure, cholesterol, or blood sugar levels that are typically associated with obesity. Some of the obese people in the study, in fact, were in much better metabolic health than some who were considered to have “healthy” weights.

“We found that 23.5 percent of normal-weight adult Americans — or about 16.3 million people — are metabolically abnormal when it comes to heart-disease risk,” said Rachel Wildman, the study’s lead author, in a written statement.

I can’t say it enough: Skinny people need to exercise, too.

That’s why earlier this summer I blogged about research suggesting that being thin and unfit could set you up for diabetes as well as heart disease. And how the size of your waist is far more important than the number on the scale. If you carry a genetic predisposition towards any number of a variety of health conditions, exercise is often a key way to lower your risks.

Weight-bearing exercise, such as jogging and jumping rope, is also critical for strengthening and maintaining your bones and reducing your risk of fractures later in life. It boosts HDL or “good” cholesterol. It lowers blood pressure. It even helps breast cancer patients live longer.

As a practicing physician for 30 years, I always preferred to prescribe exercise rather than medication. Missing exercise means your body is just plain missing out.

Got rheumatoid arthritis? Get rid of your cigarettes. New research suggests that your aching joints will thank you for it.

For years, scientists have known that smoking increases a person’s risk for developing this inflammatory condition, which causes pain, swelling and stiffness in the joints.

Studies also indicated that tobacco smoke increases the severity of the disease in those who have it.

Now comes the first solid evidence that kicking the habit may actually help arthritis sufferers control their disease.

Rheumatoid arthritis patients who stop smoking “may see an improvement in the number of joints that hurt them every day and in how they feel overall,” said Dr. Mark C. Fisher, leader of the new study in a written statement. The results were presented recently at the Rheumatology Annual Scientific Meeting in San Francisco.

Compared with rheumatoid arthritis patients who were still smoking, those who had recently quit had fewer measures of active disease, researchers determined. Their joints were not as tender or swollen, and levels of C-reactive protein – a measure of inflammation in the body – were also much lower.

The results, they believe, suggest that stopping smoking can lessen rheumatoid arthritis symptoms “over and above current medical treatment.”

Of course, there are myriad other benefits to giving up smoking. Cigarette smoke – including secondhand smoke – has been linked to more than a dozen of the health conditions measured by the Navigenics genetic risk assessment, including multiple sclerosis, breast cancer and heart attacks.

That’s not all.  I recently blogged about how smoke can hinder memory and cognition, possibly setting up smokers for Alzheimer’s disease.

The important thing to remember is that many of these studies found it is never too late to stop smoking. Don’t kick yourself for having started in the first place. Just be sure to kick the habit.

I call it the “nickel and dime” approach to losing weight. 

As anyone who has ever looked under their couch cushions for loose coins knows, small change can add up. And when it comes to losing weight, small changes can also make a big difference. In fact slow and steady is the best way to sustain weight loss.

Thing is, many dieters unsuccessfully attempt a major makeover of their eating habits, giving up all pleasurable foods or starving themselves to reduce their calorie intake – and their waistline. Those strategies, however, are generally not ones people are able to stick with for a long time. So more often than not, the diet ends and the weight slowly (or not so slowly) comes back on, and the health benefits gained from weight loss slip away.

My “radical” suggestion is to consider something not at all radical: Making small, simple changes for life. Not only are they the easiest to attempt, they are also often the most successful.

I talked to my patients frequently about this approach in my 30 years of medical practice and even included a number of suggestions in a book I wrote about weight loss. But here, I thought I’d share a “CliffsNotes” version on how to eat what you really like and lose weight, too.

No, this isn’t one of those “sounds too good to be true” meal plans like “the Chocolate Diet” or the “7 Day All You Can Eat Diet.” The guiding principle is eat what you’re eating now, just eat a little bit less of it.

So how does that work? It’s simple math. If you eat 100 fewer calories per day, you’ll keep an extra 10 pounds off your body every year.

Like to eat a sandwich for lunch? If you simply remove one of the slices of bread and squish the sandwich together, you’ll have trimmed 80 calories from your daily diet, and about 8 pounds over the course of a year. I call these pounds “year-pounds.” Divide the calories by 10 and that’s how many pounds you will avoid in one year if you remove those calories from your normal eating plan.

A can of soda containing 140 calories represents 14 year-pounds. Two ounces of chocolate will set you back 28 pounds if you eat them every day for a year.

How else can you make small changes that add up?

• Know your foods.  If you read labels, you can save pounds. Calorically, a bagel (without cream cheese, no less) is worse than a donut. No one will argue that a donut is nutritious or healthy, but if you’re only focusing on your weight, a donut is a better choice. And in fact generally if you lose weight you will be healthier regardless. The best is to eat good food, just less of it. But that is too big a step for many people who have failed at weight loss before. So, just start simply with less food, of any kind.  Remember that every bite counts. If a food item is literally “to die for”, something you’re not willing to pass up, help yourself – just don’t finish it all. Two bites of a burger left behind on a daily basis saves 20 to 25 pounds in two years.
• Make simple substitutions. If you don’t have your heart set on granola, go with oatmeal. You’ll save yourself 125 calories in a half-cup serving (12.5 pounds per year).
• Do your homework. Reading articles like Prevention magazine’s “100 Ways to Cut 100 Calories” may be helpful.

Our country is currently experiencing an obesity epidemic, which sets people up for high blood pressure, osteoarthritis, type 2 diabetes, coronary artery disease and stroke. If you carry a genetic predisposition to some such conditions, excess weight can increase your risk even further. Being overweight can even increase your risk of developing some cancers.

Skipping the milkshake while still enjoying your daily super-sized fast food meals probably will not transform you into a size6, but it is a big step in the right direction (26 or so pounds over a year). So remember, when you are reaching for something to eat, small changes really do make a big difference.

As we pointed out in our blog a few weeks back, the Scripps Translational Science Institute has launched an ambitious 20-year study on how people respond to genetic test results, using the Navigenics service as a basis for the research.

Upon learning they are at increased genetic risk for conditions such as obesity, diabetes or cancer, do people start to exercise more and eat a little less? Are they more conscientious about going to the doctor at the first sign of trouble? Do they ignore the information entirely, refusing to kick their pack-a-day habit?

Previous smaller studies have found that genetic information holds promising motivational potential. Now, the Scripps study’s principal investigator, Dr. Eric J. Topol, plans to follow 10,000 adults to find out more.

He already has one very important set of results in hand—his own.

Topol had his own DNA scanned, and as he told the Los Angeles Times, the results were somewhat surprising. A long-time cardiologist, he found out he is at increased risk of heart attack. But he had no known common genetic markers for colon cancer, which he found surprising given his family history of the condition.

Study enrollment started not too long ago, but already Topol has noticed one particular group of people has been especially interested to learn what their genes might have to say about their health—those who are adopted.

“This is the first time they’ve been able to get any family history about their life, because they don’t know their parents at all—don’t know anything about their maternal and paternal blood lines,” he said.

Any adult can sign up for a Navigenics genetic test. This Scripps study, however, is only open to employees, family and friends of the Scripps Health System in San Diego.