Slides which accompany the talk Paula Nenn gave to the Quantified Self San Diego Group

1. Translating Advanced Science into Personalized
Health and Wellness
Paula J Nenn MD
Senior Medical Director

2. Who? What? Why?
• 501c3 Non-profit research foundation
• Formed 2 ½ years ago, San Diego based
• Self-care and personal health accountability key to US
economics
• New science – 800 articles per DAY!
• Public Interest in all things ‘alternative’
• New science – personalized medicine, genomics, systems
biology, early predictive biomarkers
• Personal health tracking devices
• Bring it all together into one program?
Optimal Health
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3. ‘New’ science
preventive / predictive conventional diagnostics
functional assessments
EARLIEST SUB-CLINICAL IMBALANCE clinical diagnostic
AND RISK FACTOR BIOMARKERS threshold of disease
DYNAMIC CONTINUUM
optimal sub-optimal pre- chronic
EARLY DETECTION
health health disease disease
CHRONIC DISEASES
NEVER JUST HAPPEN
TO YOU, THEY ARE THE
END RESULT OF A
LONG, PROGRESSIVE
DECLINE.
Hyperinsulinemia
Insulin resistance
Cardiometabolic
American Diet
Syndrome
Standard
Pre-Diabetes
Diabetes
Diabetes Complications
- Leg Amputations
- Blindness
- Kidney & Heart Disease
- Erectile Dysfunction, …
Optimal Health
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4. Tree of Health and Disease
PULMONOLOGY CARDIOLOGY
ENDOCRINOLOGY IMMUNOLOGY
GASTROENTEROLOGY NEUROLOGY
PSYCHIATRY ONCOLOGY
PRE-DISEASE
Clinical Diagnostics
Functional Imbalances
Genetic Predispositions Systemic Inflammation
( gate-keepers )
Oxidative Stress
Functional Assessment Biomarkers SUB-OPTIMAL HEALTH
SPIRITUAL &
MACRO & MICRO SOCIAL BALANCE
NUTRITION
SLEEP, EMOTIONAL & MENTAL
CIRCADIAN RHYTHMS BALANCE AND
PHYSICAL ACTIVITY &
& RESTORATION ‘ENERGY SYSTEM’
STRUCTURAL BALANCE STRESS RESILIENCE
BALANCE
MICRO ENVIRONMENTAL
PROTECTION Optimal Health
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5. Optimal Health and Prevention Program
1 Comprehensive Predictive,
OHP Preventive Functional
Program Biomarker Assessment
Optimal Health OHP Dx
GPS
Translational Algorithm &
2 Artificial Intelligence
1
3Personalized, Integrative Self-
care Recommendations
3
OHP Rx
Genetic Predispositions
4 Ongoing Educational,
( gate-keepers ) Optimal Health Coaching and
Functional Assessment
Biomarkers Progress Monitoring Support
roots & trunk
SPIRITUAL &
MACRO & MICRO SOCIAL BALANCE
NUTRITION,
AIR, WATER
SLEEP,
CIRCADIAN RHYTHMS
PHYSICAL ACTIVITY & EMOTIONAL & MENTAL
& RESTORATION
STRUCTURAL BALANCE ‘ENERGY SYSTEM’ BALANCE AND
MICRO ENVIRONMENTAL BALANCE STRESS RESILIENCE
PROTECTION Optimal Health
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6. Demonstration Project
• 100 subjects chosen from volunteers
• Age, gender, ethnicity matched
• Each acts as their own control
• Start Spring 2011
• In collaboration with Scripps Center for Integrative
Medicine
• Age ≥ 18
• Exclusion criteria: acute illness, pregnancy
• Current chronic illness not an exclusion criterion but must
be stable
• Consent from primary physician
Optimal Health
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7. Week 1
Registration,
EHR &
Questionnaires
10 2
9 3
8 4
7 5
Optimal Health
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8. Week 1: Blood and Urine tests
Urine & Blood Tests
&
questionnaires
10 2
9 3
8 4
7 5
Optimal Health
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9. Week 2 - Genetics
1
SNPs
(Genomic Saliva
10
Panel)
& questionnaires
9 3
8 4
7 5
6 Optimal Health
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10. Week 3 – Autonomic Nervous System
1
10 2
24-hr ABPM
24-hr Holter
9
Saliva Cortisol + DHEA
& questionnaires
8 4
7 5
6 Optimal Health
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11. Week 4 - sleep
1
10 2
9 3
Sleep Assessment
8 EEG + Oximetry
& questionnaires
7 5
6 Optimal Health
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12. Week 5 & 6: Caloric Balance, Sleep Actiography
1
10 2
9 3
8 4
Physical Activity
7
Food Diary, FFQ
6 Optimal Health
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13. Week 7: Non-Invasive Physical Tests
1
10 2
9 3
8 4
Physical Tests 5
(Onsite)
6 Optimal Health
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14. Week 8: MD and coach
1
10 2
9 3
START…
Integrative 4
MD Consult
7 5
6 Optimal Health
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15. Week 8: Start Program
• Personalized Interventions
• Nutritional recommendations
• Physical activity
• Breathing
• Sleep
• Environmental toxicity
• Stress
• Energy medicine
• Spirituality / connections / gratitude
Optimal Health
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16. Week 26
1
10 2
Interim Data 3
Analysis
Week 12
8 4
7 5
6 Optimal Health
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17. Week 52: Program Finish
1
Final Data 2
Analysis
9 3
8 4
2012
7 5
6 Optimal Health
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18. Biomonitoring
• Assessment Phase
• 24 hour HRV
• 24 hour AMBP
• 2/52 Body Media – calorie balance, sleep
actiography
• 3 day Apnea link sleep apnea screening
• Zeo Sleep Monitor 7/7
• Text and IVR food diary
• Intervention
• Body Media
• Zeo
• Emotional sampling
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• Biofeedback devices: meditation, HRV etc O p t i m a l Health
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19. Questions?
Paula.Nenn@OptimalHealth.org
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