Naturopathic Medicine and Prevention of Cardiovascular Disease: A new study shows benefit!

View our entire May e-newsletter, Reversing Heart Disease, here.

Dr. Jennifer Wheeler, ND

An exciting new study just released in April 2013 in Canada’s top medical journal, the CMAJ, demonstrated how naturopathic medicine can help prevent cardiovascular disease. It was a milestone achievement for the naturopathic community, as the study was conducted by the naturopathic doctors from the Canadian College of Naturopathic Medicine in Toronto, and was one of the first to compare naturopathic medicine as a system of medicine to that of our standard medical system.

The study followed 207 Canada Post workers, aged 25-65, over the course of one year. Each participant was evaluated for cardiovascular risk before and after the study, including body weight, waist circumference, cholesterol levels, fasting blood sugar and blood pressure. All participants received standard conventional care from their family physician throughout the study period. The control group only received conventional care while the naturopathic intervention group included 7 visits over the course of the year. Naturopathic interventions were limited to individualized dietary and lifestyle counseling, stress management, exercise and a select list of dietary supplements with proven cardiovascular benefit. These included fish oil, plant sterols, cinnamon, ALA and CoQ10.

The results showed that the naturopathic intervention group had a 17% decreased rate of metabolic syndrome over the control group! Metabolic syndrome is a condition that is a precursor to many diseases, including cardiovascular disease, type 2 diabetes and cancer. It is diagnosed if patients have 3 of 5 risk factors, including abdominal obesity, elevated triglycerides, low HDL cholesterol, elevated blood pressure and elevated fasting blood sugar. Participants in the naturopathic group had a 6.5 mmHg drop in systolic blood pressure, lost more inches around their waist and reported improvements in overall well-being compared to the control group.

The study also found a 3% decreased 10-year risk of a cardiovascular event compared to the control group. Now, 3% may not sound like a lot, but it means that 3 people out of 100 would be predicted to not have a heart attack or stroke in the next 10 years. What is also interesting is that the control group, who only received conventional care, had their 10-year risk increase by about 1%. This again, may not sound like a lot, but if we take it in context of prevention, it means that most people receiving only standard medical care are not receiving the care or support that may be necessary for them to prevent having a heart attack.

The study is a good start at demonstrating the benefits of naturopathic medicine that we see daily in practice. While many of our specific interventions have either evidence-based research or long-term clinical usage, the profession is often criticized for not having enough scientific research behind its therapies. This study, designed and carried out by naturopathic doctors, shows that the profession is striving to show that our approach to patient care does work. It also shows how naturopathic doctors can have real and significant impact in the prevention of chronic disease.

One of the most-cited criticisms of the study is that it may only show that increased length of patient-doctor interaction is beneficial, as opposed to a particular system of medicine or intervention. The study participants spent a total of 4 hours with their naturopathic doctor over one year. The time spent with their medical doctor was not tracked in the study, but it can be assumed that it was not nearly as long. The time spent with patients is critical for patient success, especially when dealing with the long-term management of blood pressure, blood sugar and weight management. Increased frequency of visits leads to higher accountability and success with dietary and lifestyle changes. Increased visit duration leads to better patient knowledge about their condition and often better compliance. Patient success may not depend so much on the exact type of intervention, but on the amount of quality interaction with their primary care provider, no matter whether the provider is a naturopathic doctor or family physician.

The study also did not allow for utilization of the full potential that naturopathic medicine offers. For the purposes of the study, the interventions were limited to a very small list. In naturopathic practice, the goal is to treat the whole person, as opposed to a specific condition the person may have. In this study, there was far more focus on treating a specific condition than is common in typical naturopathic practice. It did not acknowledge many of the other risk factors that naturopathic doctors are evaluating for and treating when dealing with patients with increased cardiovascular risk. For example, the study did not allow for treatment of other co-existing conditions that may contribute to cardiovascular risk, such as dental disease, digestive diseases or exposure to environmental toxins. If the study would have allowed for more comprehensive treatment options, including the full range of nutrient support, herbal therapies, homeopathics, IV therapy, acupuncture and physical therapies, an even higher level of benefit to cardiovascular risk factors would likely have been achieved! We look forward to future studies that demonstrate the power of naturopathic medicine.

The research article is available free online at:
http://www.cmaj.ca/content/early/2013/04/29/cmaj.120567

Seely, D et al. Naturopathic medicine for the prevention of cardiovascular disease: a randomized clinical trial. CMAJ April 29, 2013 First published April 29, 2013, doi: 10.1503/cmaj.120567