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Q and A with Charles A. Moss, MD, author of Power of the Five Elements: The Chinese Medicine Path to Healthy Aging and Stress Resistance

Posted by >>>>> on June 6, 2010

Q. Adaptation is a central concept in your book, Power of the Five Elements. Can you explain adaptation for us?

A. Effectively adjusting to changing life circumstances is the marker of a healthy person. Remarkably the Taoist physicians used the same language 2000 years ago. Life is a constant state of adaptation. Every time adaptation is inadequate, increased cortisol and stress hormones result with dire consequences. If you are in a traffic jam and are seething because you can’t do anything about it, you are poorly adapting; if you see it as an opportunity to do some deep breathing and be grateful for your life, you are adapting well. Adaptation occurs moment by moment in every cell of your body as well as how you adapt with your attitudes and emotional state. Cells, people and species that don’t adapt go extinct. Don’t let your cells go extinct!

Q. What are the Adaptation Types?


A. The basis of the Adaptation Types is the Five Elements of Chinese medicine, which has been the core aspect of my practice for 30 years, drawn from 2000-year-old ideas. What is most important is that the Five Types brings clarity to constitutional patterns, looking at the person not just the symptoms. When my patients understand why they react to certain stress in their own unique way they can become more resistant to the negative impact of poor adaptation. The Five Adaptation Types are a way to map and organize a person’s stress response and provide the tools to reduce the stress. For example, the Wood type responds with frustration and anger if feeling restrained and unable to control their environment, while the Metal Type responds with withdrawal melancholia and poor self-esteem if they do not feel well-respected and experience life’s perfection. This ‘map’ provides a way to be mindful and observant of the stress response and then decouple from it and achieve objectivity and not emotional reactivity. This is the path to ramping down the cortisol response.

Q. How did you get interested in integrative medicine and Chinese medicine?
A. In medical school in the 1960’s two things happened for me that set me on this course: We started to eat a macrobiotic diet and I experienced personally the power of diet on health. The second was my interest in a deeper understanding of what made a person vulnerable to poor health and how to look at the whole person. Surprisingly the answers to these questions led me to traditional Chinese medicine.  As opposed to what I was learning in medical school where allopathic medicine could not explain the mind-body connection, traditional Chinese medicine looked at the whole person body, mind and spirit. Once I studied Five Element acupuncture in England in the 1970s that I realized what was missing in Western medicine was the focus on the person who had the disease, not just the disease. Look at the author as well as the book. This is my focus in my practice.

Q. In both Power of the Five Elements and your earlier book, The Adaptation Diet, you talk  a lot about cortisol. Why is this so important?
A. In talking to my patients I realized that few people understand what stress can do to their health and the importance of cortisol.  Cortisol is the main stress hormone made in the adrenal glands. It is necessary for survival, without it we wouldn’t last more than a few hours. It is the main way we respond to stress over time-mobilizing energy through release of fatty acids, raising blood sugar, moving blood from the digestive system to the muscles, suppressing the immune system, reducing inflammation and decreasing sex hormone production. It is catabolic breaking down muscle for energy. All these changes help survival and after the stress is resolved, it all goes back to normal—except in our life styles, the type of stress many of us experience does not easily resolve-work, family, financial, terrorists etc. not just surviving a predator or getting lunch. Elevated cortisol continues to change the body as above and is associated with obesity, diabetes, heart disease, high blood pressure, depression, increased cancer risks.

Q. How do we normalize cortisol levels through diet?
A. There are 5 aspects of diet that reduce cortisol: 1) reduce high glycemic foods that spike blood sugar and insulin; 2) reduce pro-inflammatory fats in red meats, fried foods, baked goods; 3) eat smaller more frequent meals to keep blood sugar even 4) eat less of the common allergenic foods and identify any food allergies 5) use adaptogenic foods, such as flaxseed powder, fatty fish and fish oils supplements, broccoli; and anti-inflammatory foods like almonds, walnuts, avocado and spices like curcumin, ginger.

Q. What do people not understand about the obesity epidemic?
A. It’s not just about diet or calories. Anything that raises cortisol levels increases abdominal fat. Any increase of visceral fat, even as little as five pounds, raises cortisol levels  from the fat cells setting up a vicious cycle of elevated cortisol increasing fat accumulation and more visceral fat cells making more cortisol. Diet can play a major role in reducing cortisol if emphasizing the approach above, but changing attitudes and reducing the stress response is just as important in reducing cortisol and obesity.

Q. What new information do you offer in your new book Power of the Five Elements and in your earlier work, The Adaptation Diet?
A. There has been little discussion of the keys for improved adaptation to prevent obesity and chronic disease-good dietary habits, healthy attitudes and beliefs and good self-care. Both books give a template on how to reduce cortisol in a clear and concise manner. The books give the reader the information to make a big difference in their health and what they can control without needing to depend on a health care system that ignores these areas. The reader can be empowered to make the changes in eating habits and attitudes that will pay off in weight loss and better health.

Q. Why is the research on allostasis and the fMRI so important to understand?
A. Academic medicine always taught that after a change in organ function, increasing heart rate with exercise for example, the body would go back to the preset state, returning to normal heart rate after exercise, called homeostasis. This is true for the majority of functions such as kidney function, setting blood pH levels, however it is not true for the control over the stress hormone state. With long-term stress, or a traumatic event, which so many of us have experienced, the midbrain resets the level of stress hormone at higher point even if the original stress is resolved. This is called allostasis and the impact it has on health is called allostatic load. I see in my patients evidence of this where they have not truly recovered from trauma whether it is a divorce, abuse, accident or other unexpected event leading to wear and tear from cortisol and risks for obesity and disease.

Functional MRI scans have shown the outcome of allostatic load. The brain remodels itself under the burden of too much cortisol. The part of the midbrain which contains detailed and specific emotional memories, the hippocampus is injured buy excess cortisol and actually decreases in size. Studies on depressed patients showed a 20% decrees in the size of the hippocampus. While this is happening, the part of the midbrain, which contains the fear and anger centers, and non-specific memories of trauma and stress enlarges creating a scenario like PTSD, a vague feeling of unease and anxiety. In addition, this brain remodel leads to more cortisol secretion and poor control over the regulation of the adrenal glands.

Knowing that these changes take place with long term stress gives the reader an incentive to follow the programs in both books to improve adaptation.

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