Organised by:

Malaysian Healthy Ageing Society

Co-Sponsored:

Paths to Wellness

& Anti-Ageing Through

Asian Healthcare Traditions

Prof Gerard Bodeker Chair Global Initiative For Traditional Systems of Health,

Oxford, UK;

Division of Medical Sciences, University of Oxford,

Mailman School of Public Health, Columbia U., New York

www.giftsofhealth.org

Asia’s Major Healthcare Traditions

Traditional Chinese Medicine (TCM)

In addition to China, TCM has strongly influenced healthcare traditions

of Japan, Korea, Vietnam & of the Chinese diaspora throughout South-

East Asia – & hence has influenced local SE Asian traditions

Ayurvedic Medicine

From its home in India, Ayurveda has influenced the traditions of

Nepal, Tibet, Pakistan and Bangladesh as well as much of SE Asia,

including Burma, Thailand, Cambodia, Malaysia & Indonesia.

Foundations of Asian Medical Systems

Asian medical systems have in common:

THEORY: Concept of Energy – energy is the basis of matter & must be treated if matter is to be influenced

Concept of inter-linkage of mind-body-spirit-environment

Concept of balance – lack of balance resulting in dis-ease

Theory of Elements

Theory of Body Types

DIAGNOSTIC FRAMEWORK: Thermo-regulatory concept: hot/cold; damp dry; etc.

Toxicity & Detoxification

Lifestyle & nutritional perspectives to:

understand disease origins

prevent & manage disease;

promote wellbeing

Pulse as the source of readable information about the state of the entire physiology

GLOBAL TRENDS

Estimated Global Market Size of the

Wellness Cluster

Reactive

Proactive

Wellness Paradigm

Treatment Paradigm

A US$1.9 Trillion Global Market

Spa

Complementary & Alternative Medicine

Healthy Eating / Nutrition & Weigh Loss

Fitness & Mind-Body

Wellness Tourism Medical Tourism

Workplace & Wellness

Beauty & Anti-aging

$60

$113

$276

$106

$243

$30

$390

$679

$50

(US$ billions)

Source: SRI International, 2010 Report

Integrated,

Wellness-

oriented

Approaches (to

improve quality

of life)

Conventional,

Medically-

oriented

Approaches

(to solve

problems)

Preventive/Personalised Health

PHYSICAL THERAPIES

Acupuncture Effective in pain management – post operative care, cancer

pain, etc.

More effective than physiotherapy in managing low back

pain

Effective in stroke rehab.

Yoga US reviews of studies suggest that yoga may

reduce many insulin-resistant syndrome related risk factors for CVD,

improve clinical outcomes

may aid in the management of CVD

(Innes et al 2005).

Reduce age related deterioration in cardiovascular functions (Bharshankar et al 2003).

Yoga - Reduce age related deterioration in cardiovascular functions (Bharshankar et al 2003).

Tai Chi & Falling

Tai Chi – most effective means of preventing falling in

the elderly Wolf SL, O'Grady M, Easley KA, Guo Y, Kressig RW, Kutner M. (2006)

Choi JH, Moon JS, Song R. (2005)

American Geriatric Society (2011):

Recommendation that Tai Chi lessons and reduced

medication should be used to prevent falls in the

elderly.

Meditation Research on Meditation (Transcendental Meditation- TM)

has shown:

Increased pre-frontal brain wave coherence

decreased blood pressure and reduced insulin resistance

among patients with coronary heart disease (Labrador et al,

Archives of Internal Medicine (2006)

decreased medical care utilization and hospitalization

increased pre-frontal brain wave coherence

significant increase in leadership behavior

The Raj - Ayurvedic spa, Iowa, USA

NY Times & Conde Naste ‘best destination spa”

.

De-tox & Ayurveda

Lipophilic toxicants (man-made toxins), such as PCBs, DDEs,

DDT and other chemicals and pesticides tend to accumulate in

our fat tissues.

They have been associated with hormone disruption, immune

system suppression, reproductive disorders, cancer, and other

diseases.

Drawing on published research, clients at The Raj are informed

that the Ayurvedic programs offered “are capable of dislodging

lipophilic and other toxins from the tissues and reducing their

concentration in the body”.

The Raj has a high percentage of repeat guests.

HERBAL MEDICINE

Ling Zhi

(ganoderma lucidum)

Used as medicine in China for more than 2,000 years:

has anti-tumor effects

has immunomodulatory and immunotherapeutic activities

inhibits platelet aggregation

lowers blood pressure

lowers cholesterol, and

lowers blood sugar

has anti-bacterial and anti-viral activities

Ginger against Nausea

Meta-analyses of clinical trials finds that ginger significantly reduces nausea associated with:

Postoperative sickness and vomiting Thompson HJ, Potter PJ

(2006). Pregnancy Marcus DM, Snodgrass WR. (2005) Cancer Manusirivithaya S, Sripramote M, Tangjitgamol S,

Sheanakul C, Leelahakorn S, Thavaramara T, Tangcharoenpanich K. (2004)

Motion sickness Lien HC, Sun WM, Chen YH, Kim H, Hasler W, Owyang C. (2003)

Turmeric

ANTI-CANCER Curcumin’s potential anticancer effects stem from its ability to kill cancer cells without killing healthy cells. It has recently been shown to have phyto-estrogenic activity that might contribute to activity against breast cancer

PAIN REDUCTION A daily dose of 2 grams of Curcuma domestica extract was found to provide pain relief equivalent to Ibuprofen for the relief of pain associated with osteoarthritis of the knee

ALZHEIMER’S DISEASE

Research on curcumin, a phenolic compound

from turmeric, has shown decreased Beta-

amyloid plaques, delayed degradation of

neurons, metal-chelation, anti-inflammatory,

antioxidant & decreased microglia formation,

the overall memory in patients with AD

improved.

Gotu Kola/Pegaga/Brahmi

(Centella Asiatica)

• Stimulates collagen production – skin repair,

wound healing.

• Enhances memory & learning ability

Ginkgo biloba Anatomical & functional changes in visual organ in children

& adolescents, age between 11 & 19 years, with long lasting diabetes mellitus (DM)type 1 & taking Egb 761 as an adjuvant was evaluated which showed that Egb 761 seems to be good adjuvant in patient with long lasting DM. [Article in Polish] Bernardczyk-Meller 2004

G. biloba induced reduction of both classes of prostanoid metabolites in healthy volunteers, but not in T2DM subjects. May suggest a nonselective inhibition of COX-1-mediated TXA(2) in platelets and COX-2-mediated PGI(2) production by the endothelial cells and perhaps platelet-enriched levels of arachidonic acid or COX-1 activity, or both, in T2DM subjects. Kudolo GB, Dorsey S, Blodgett J. 2002

Panax ginseng C.

It has been demonstrated that for the first time C-reactive protein could be altered by ginsenoside Re (Re, a major component of ginseng) treatment, indicating that Re may improve diabetes and its complications by alleviation of inflammation. Cho 2006

It is indicated that oxidative stress is increased in the diabetic rat kidney and sun ginseng (heat-processed Panax ginseng C. A. MEYER at 120 degrees C) can prevent renal damage associated with diabetes by attenuating the oxidative stress. Kang 2006a

American ginseng reduced postprandial glycemia in subjects without diabetes only when administered 40 min before an oral glucose challenge. Vuksan 2001

Blood sugar was lowered in alloxan diabetes of rodents [Article in Russian] Molokovskii 1989

St. John’s Wort

(Hypericum).

*Hippocrates, Pliny and Galen had all described the use of

Hypericum for the treatment of mental disorders

*An RCT published in the BMJ on 324 patients with mild to

moderate depression, compared St. John's Wort (Hypericum

perforatum), with the recommended dose (150 mg) of

imipramine, one of the most commonly used tricyclic

antidepressants.

*Results: Hypericum extract is therapeutically equivalent to

imipramine in treating mild to moderate depression, but patients

tolerated Hypericum better (Woelk, 2000).

Safety

Databases & physicians handbooks available on safety of:

Herbal medicines, Herb-drug interactions; Other TCAM

practices

UK: Royal Pharmaceutical Society of Great Britain:

‘MedicinesComplete’ database includes Herbal Medicines and

Dietary Supplements: www.medicinescomplete.com

USA: Natural Medicines comprehensive database

L. Braun & M Cohen (2010), Elsevier Press: “Herbs & Natural

Supplements: An Evidence Based Guide”

FOOD & NUTRITION

TCM & Ayurveda

Foods have properties - inflammatory, cooling etc.

Food selected according to (a) body type;

(b) health condition;

(c) season & geography

REFERENCES:

Ayurveda: “Heaven’s Banquet”.

TCM – in preparation, Eu Yan Sang

White Rice vs Brown Rice Harvard research: Americans who eat two or more servings of brown

rice a week reduce their risk of developing Type 2 diabetes by about 10

percent compared to people who eat it less than once a month.

And those who eat white rice on a regular basis — five or more times a

week — are almost 20 percent more likely to develop Type 2 diabetes

than those who eat it less than once a month.

Just replacing a third of a serving of white rice with brown each day

could reduce one’s risk of Type 2 diabetes by 16 percent, a statistical

analysis showed. A serving is half a cup of cooked rice.

Red Rice Yeast –

Cholesterol Inhibition

Red yeast rice is the product of yeast grown on rice, and is served

as a dietary staple in some Asian countries.

It contains several compounds collectively known as monacolins,

substances known to inhibit cholesterol synthesis.

Basis of lovastatin (Mevacor® by Merck).

In US controversy over licencing – drug or food?

Available in Asia, Europe & online

Japanese Diet

Seaweed:

mineral macronutrients include sodium, magnesium, potassium, chlorine, sulfur and phosphorus; seaweed is one of the richest plant sources of calcium

micronutrients include iodine, iron, zinc, copper, selenium, molybdenum, fluoride, manganese, boron, nickel and cobalt.

Green tea:

People who were frequent drinkers of green tea (>6 cups per day were less likely to develop diabetes than those who drank less than 1 cup per week.

This was strongest in women and in overweight men.

No association was found with black and oolong teas and reduced risk for diabetes.

(Iso, Date, Wakai, Fukui, Tamakoshi, 2006)

Japan - Onsen

The Japanese Onsen tradition is centred around

hot springs in this volcanically active country.

Traditionally used for public bathing, Onsen have

become major features of Japan’s tourism

industry.

Purity of water, mineral richness and heat are key

features of the Onsen experience.

Reflecting the globalization of Asian health

cultures, Onsen are found in spa settings in many

different parts of the world.

.

Thai Traditional Massage

Drawing on basic principles of the Wat Pho tradition

of Thai massage and the Lana traditions of Northern Thailand, Thai spas draw on local as well as generic national concepts and products to integrate into their treatment regimens.

Wat Pho, the Temple of the Reclining Buddha, in Bangkok, adjoins the Grand Palace and is known as the birthplace of traditional Thai massage.

In the era before the temple was established, the site was a centre for training in traditional Thai Medicine, which in turn has it roots in Ayurveda.

UNESCO Heritage Listing

‘

Traditions of the Malay Kingdoms

The indigenous health traditions of Malaysia and

Indonesia have also been the source of a unique

set of spa programmes and ambiances.

These have taken village or kampung traditions, as

well as those from royal courts, and in the

contemporary context, placed them within a spa

and wellness setting.

Malaysia’s MOH is now licensing training courses

in Urut Melayu – Malay massage.

.

.

Philippines Traditional Philippine medicine has its roots in the

many ethnic groups of the Philippine islands.

The traditional massage system of the Philippines, known as hilot, is equally diverse in practice and tradition.

Now hilot is becoming standardized & is also incorporated into contemporary spa programmes in the Philippines. EU funding is supporting this.

.

.

Global Spa Industry

,

THANK YOU

A Global Perspective on Natural Healthcare

Wellness is now a $1trillion industry (SRI International 2008).

Within this, Asian healthcare systems and

traditions are globalizing

(WHO Global Atlas on Traditional, Complementary &

Alternative Medicine, 2005)

Global Wellness Industry

,

.

.

.

Cultural Traditions of Spa & Wellness in

Asia-Pacific

Syncretism – The Fusion of Traditions:

Preserving core principles & practices – fusion or confusion?

Indigenous Issues, Spa Industry Policy, International Law

Deriving knowledge from ancient traditions

Who owns the knowledge?

Informed consent & benefit sharing

Standards of ‘best practice’ with respect to Traditional Therapies are emerging

.

.

THANK YOU