1. Sustainable Medicine New Directions for Research
David Servan-Schreiber, MD, Ph.D Clinical Professor of Psychiatry, University of Pittsburgh
Lecturer, Faculté de Médecine Lyon

2. Current Model

3. The Tibetan Principle Myocardial infarction, Pneumonia, Appendicitis…
CAD, Cancer, Diabetes, Depression, Arthritis...

4. Coronary Artery Disease
Ornish, 1995 JAMA
Treatment as usual
Vegetarian diet + exercise + meditation + group support
Baseline
5 years later
Control
Program
Myocardial Perfusion 13 N PET Scan

5. A Story
Pittsburgh, late1992

6. Epidemic 1 - Evolution
SEER, 2003 NCI

7. Epidemic 2 - Distribution

8. Key difference = Lifestyle
For 100,000
Sasco, 1989 Rev Med Int

9. Prevention AND Treatment
Lifestyle factors can cause or protect from cancer
Can they affect treatment too?

10. Behavioral Changes and Breast Cancer
Intervention
Control
68% reduction in mortality
Andersen et al., 2008 Cancer

11. Nutrition

12. Mediterranean Diet
Eposito et al, 2004 JAMA

13. Omega-3 / Omega-6
Feller et al., Jal. Am. Chem. Soc.., 2002

15. Duckett et al., 1993 J Animal Sci

16. Transformation of food chain
x20
Omg-6 /Omg-3
x15
x10 x6
Ailhaud et al., Prog. Lip. Res., 2006 – Simopoulos & Salem. NEJM, 1989

17. Evolution of Diet WW II % Calories Saturated Fat 20
Omega-6 Fatty Acids 10
Omega-3 Fatty Acids
- 4M
- 10,000
1800
1900
2000
Leaf, A. and P. Weber Am. Jal. Clin. Nut. 1987

20. Omega-6 fatty acids and mammary tumors
Nb of tumors
Days post graft
Carroll et al, 1975 Cancer Res.

21. Advanced Breast Cancer
Gago-Dominguez et al., 2003 Brit J Ca – Singapore Prospective women

22. Membrane Protection Neurones exposed to beta-amyloid
Neurones without anything
Neurones with omg3 exposed to beta-amyloid
Neurones with omg3
Florent et al. Jal. Neurochem., 2006

23. Prevention: Framingham Study
RR=0.53
Schaefer et al, Arch Neurol.

24. Treatment: Omega-3 AD Study
Placebo
Freund-Levi et al, 2006 Arch Neurol.

25. Studer et al, Arch Int. Med. 2005
Statins or Omega-3s?
Cardiac Mortality
-22%
-32%
Studer et al, Arch Int. Med. 2005

26. Studer et al, Arch Int. Med. 2005
Statins or Omega-3s?
All Cause Mortality
-13%
-23%
Studer et al, Arch Int. Med. 2005

27. Flaxseed Project 5% flax seed in animal feed 
Meat, butter, eggs, cheese, milk balanced in omega-3s 
Impact on human biological parameters
(INRA, CHU Rennes, CHU Lorient)

28. Childhood Cancers - Europe
Steliarova-Foucher et al., Lancet

29. Organic vs Conventional Food
42 children 2 to 5 yo - Seattle, Wash
« organic » children below EPA safety limit
« conventional » children 4 x above
Curl et al., 2003 Env. Health. Persp.

30. Summary
Many scientifically sound “complementary” and environmental approaches
Which is the best medicine? Which is more “scientific”?
No patent = no profits = no awareness

31. Sent: Thur. 02/28/08 5:40 pm To: XXX Great. Thanks
Sent: Thur. 02/28/08 5:40 pm To: XXX Great. Thanks. G is a great guy, say hi, and I will keep looking out for the good science he does. Even so, the chances of commercial success hinge on the patent life of a molecule, and we have our hands full with stuff that has that sort of potential. Best, XXX Clinical Director, XXX

32. New Research Orientations
1. “Natural”/sustainable treatments
2. “Intellectual property” protection
3. Environmental interventions

33. The End