ISCI631: Introduction

to Complementary and
Integrative Health

Class Block 2: Key Concepts of Complementary &

Integrative Medicine/Health
Instructor: Marybeth Missenda
Spring 2017
Optimal Health
 Objectives
• Discuss the evolving definition of health
• Discuss the concepts of Positive Health in the physical,
psychological and social domain
Think of someone who you think
represents health
• What makes you call them healthy?
• What qualities illustrate their health?
• What is it like when you are healthy?
 Health : An Evolving Concept

Emphasis on Focus on
Focus on Freedom the ability to what is going
survival from disease perform daily well (quality
activities of life)

(McDowell, 2006)
 Defining Health
“ state of complete physical, mental
and social well-being and not merely
the absence of disease or infirmity”
(WHO, 1948)
Historical Evolution
• Positive Psychology
• 1989 Dr Carol Ryff- Psychological well-being
• Autonomy • Positive relationships
• Environmental mastery • Purpose in Life
• Personal growth • Self-acceptance

• Dr Martin Seligman – wellbeing theory

Happiness= pleasure + engagement + meaning

“The emotional dimension of wellness involves the

capacity to experience feelings appropriate to one’s
internal and external circumstances while maintaining
an over all calm and positive outlook on life. ” (Snow,
 New Definition of Health
“ Health as the ability to adapt and self-manage, in light of
the physical , emotional and social challenges in life”
(Huber et al, 2011)
Positive Health is a broader more whole person view of health
• Stresses the ability of people to cope and adapt
• On a continuum
• Dynamic
• Shift from illness / disease to resilience and wellbeing
• More relevant to current prevalence of chronic disease over acute
disease
• Emphasis on the person > his/her illness
 Bodily Function

Limitations:
Physician response rate (30%)
Patient response rate (71%)

Bodily Mental Spiritual Quality Social Daily

Function Function Dimension Of & Function
& Life Societal
Perception Participation
(Huber et al, 2016)
Health Indicators
 Health as a Continuum
Positive Health

Disability Symptoms Signs

Illness Optimal
And Health
Disease Education growth Self
Actualization
Premature
death

(Corbin & Pangrazi, 2001)

Health as
Resilience
• The ability to bend but not
break , bounce back
• To grow in the face of
adverse life experiences
– “ The process of adapting
well in the face of
adversity, trauma,
tragedy, threats or even
significant sources of
stress” (as cited by
Southwick et al, 2014)
 Biomarkers of Resilience
Overwhelming Stressors
• Abusive relationship
Biomarkers • Lack of resources
• Ongoing Psychological worry
• Blood pressure • Loneliness (Momtaz et al ,2012)
• Stress hormones
• Immune function Familiar Stressors
• Gene methylation • Physical Activity
• Whole foods diet
• Connection to Environment
• Social connection
• Graduate School (building
(Southwick , Bonanno, Masten, Panter-Brick & Yehuda, 2014) cognitive reserve)
 Determinants of Resilience
• Biological ( genetic and epigenetic)
 Maintenance of physiological homeostasis through changing circumstances
 Able to respond to stress and restore equilibrium
• Psychological domain
 Ability to hang on to hope
 Capacity to cope
 Being able to comprehend, manage and find meaning in difficult situations

• Social connection and social capital

 Capacity to fulfill obligations
 Manage their lives with some degree of independence
 Participate in social activities including work
Resilience : Physical Domain
• Bitter and pungent flavors
• TAS2 receptors (bitter)
• mucous epithelial cells of
tongue, stomach, colon &
upper respiratory tract
• placenta and endocervix
• Heart (Foster et al 2013)
• Initiates preventative
defensive response
• Enhances gastric mucosal
protection ( Holzer & Pabst, 1999; Niiho et al, 2006; Fattori et al, 2016; Wold;e et al 2016)
 Resilience : Physical
Moderate Physical Activity as a stress stimuli
Domain
• Simple muscle contraction 
formation of reactive oxygen
species= oxidative stress
• Regular moderate Physical
Activity Promotes resilience
and adaptability by
improving…..
• Cardiovascular function
• Metabolic function
• Hormonal function
• Immunological function ABC = allostatic buffering capacity
(Li & He, 2009)
Eustress= “good stress”
Resilience : Social Domain
• Stress resilience through social
connection
– Release of oxytocin from the
pituitary gland during times of
stress
• Increases desire for social
connection ( McInnis et al,2015)
• Protects the heart from the
damages of epinephrine
• Relaxes blood vessels
– Caring for others creates
resilience (as cited by McGonigal, 2013)
Think of someone who you
think represents health
–What makes you call them
healthy?
–What qualities illustrate their
health?
Has your answer changed
since the beginning of class?
To explore this topic deeper : https://padlet.com/mmissenda/ISCI631OptimalHealth
 References
Corbin, C. B., & Pangrazi, R. P. (2001). Toward a uniform definition of wellness: a commentary. Research Digest. Presidents Council
on Physical Fitness and Sports. 3.15: 1-8

Fattori, V., Hohmann, M., Rossaneis, A., Pinho-Ribeiro, F., & Verri, W. (2016). Capsaicin: Current Understanding of Its Mechanisms
and Therapy of Pain and Other Pre-Clinical and Clinical Uses. Molecules, 21(7), 844. doi:10.3390/molecules21070844

Foster, S. R., Porrello, E. R., Purdue, B., Chan, H.-W., Voigt, A., Frenzel, S., … Thomas, W. G. (2013). Expression, Regulation and
Putative Nutrient-Sensing Function of Taste GPCRs in the Heart. PLoS ONE, 8(5), e64579. doi:10.1371/journal.pone.0064579

Holzer, P., & Pabst, M. A. (1999). Visceral afferent neurons: role in gastric mucosal protection. Physiology, 14(5), 201-206.

Huber,M., Bakker,M.H., Dijik,W., Prins, H.A.,& Wiegant, F.A., (2012). The challenge of evaluating health effects of organic food.
Operationalisation of a dynamic concept of health. J Sci Food Agric. 92(14). 2766-2773

Huber, M., Knottnerus, J. A., Green, L., van der Horst, H., Jadad, A. R., Kromhout, D., ... & Schnabel, P. (2011). How should we define
health?. BMJ: British Medical Journal, 343.

Huber, M., van Vliet, M., Giezenberg, M., Winkens, B., Heerkens, Y., Dagnelie, P. C., & Knottnerus, J. A. (2016). Towards a “patient-
centred” operationalisation of the new dynamic concept of health: a mixed methods study. BMJ Open, 6(1), e010091.
doi:10.1136/bmjopen-2015-010091
 References
Li, G., & He, H. (2009). Hormesis, allostatic buffering capacity and physiological mechanism of physical activity: a new
theoretic framework. Medical hypotheses, 72(5), 527-532.

McDowell, I. (2006). Measuring health: a guide to rating scales and questionnaires. Oxford university press.

McGonigal, K. (2013). How to make stress your friend. TED Talk Video online. bit. ly/1z7kDLE.

Momtaz, Y. A., Hamid, T. A., Yusoff, S., Ibrahim, R., Chai, S. T., Yahaya, N., & Abdullah, S. S. (2012). Loneliness as a risk
factor for hypertension in later life. Journal of aging and health, 24(4), 696-710.

Niiho, Y., Yamazaki, T., Nakajima, Y., Yamamoto, T., Ando, H., Hirai, Y., ... & Ida, Y. (2006). Gastroprotective
effects of bitter principles isolated from Gentian root and Swertia herb on experimentally-induced gastric
lesions in rats. Journal of Natural Medicines, 60(1), 82-88

Rosenthal, B., & Lisi, A. (2014). A qualitative analysis of various definitions of integrative medicine and
health. Topics Integr Health Care, 5(4).

Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J Pers Soc
Psychol, 57(6), 1069-1081

Seligman, M. (2004). The new era of positive psychology. Original. Recuperado de http://www. ted.
com/talks/martin_seligman_on_the_state_of_psychology.
 References
Snow, J. (2011). Understanding Wellness. Retrieved from
https://learn.muih.edu/courses/4993/files/321006?module_item_id=106309
Southwick, S. M., Bonanno, G. A., Masten, A. S., Panter-Brick, C., & Yehuda, R. (2014). Resilience definitions, theory,
and challenges: interdisciplinary perspectives. European Journal of Psychotraumatology, 5.

Sterling, P. (2012). Allostasis: a model of predictive regulation. Physiology & behavior, 106(1), 5-15.

Uchino, B. N. (2006). Social support and health: a review of physiological processes potentially underlying links to
disease outcomes. Journal of behavioral medicine, 29(4), 377-387.

Wölfle, U., Elsholz, F., Kersten, A., Haarhaus, B., Schumacher, U., & Schempp, C. (2016). Expression and Functional
Activity of the Human Bitter Taste Receptor TAS2R38 in Human Placental Tissues and JEG-3 Cells. Molecules,
21(3), 306. doi:10.3390/molecules21030306