A leading research journal publishes study supporting naturopathic care for high-risk heart patients.

Out-of-shape Canadian postal workers found a significant drop in
their risk of heart disease after receiving care from naturopathic
doctors, according to a new clinical trial.

The study found that workers who received naturopathic care in
addition to typical care lost weight and lowered their blood pressure,
compared with a group of workers who received only conventional care.

It’s the largest randomized clinical trial ever published on naturopathic medicine, a field of primary care that emphasizes the healing power of nature and treating the root causes of disease. The study appeared in the Canadian Medical Association Journal (CMAJ), a top 10-ranked medical research journal.

“This study is significant because prevention is one of the core principles of naturopathic medicine,” says coauthor Ryan Bradley, ND, MPH, associate director of the Bastyr University Research Institute.
“This is the first clinical research that’s evaluated the effectiveness
of naturopathic doctors at preventing disease, and it clearly
demonstrated a reduction in risk factors.”

More than 200 postal workers in Toronto, Vancouver and Edmonton were
screened for risk of heart disease, then randomly assigned to a control
group or a naturopathic care group. The naturopathic group met seven
times over the course of a year with a licensed naturopathic doctor
(ND). They received counseling on nutrition, exercise and stress, along
with common naturopathic supplements such as fish oil. Like the control
group, they also received usual care from a family physician.

After a year, the naturopathic care group was 17 percent less likely
to have metabolic syndrome, an indicator of heart risk based on factors
such as high blood pressure, high cholesterol and obesity. The group
also scored 3 percent better on the 10-year Framingham risk algorithm, a
widely used method for measuring the risk of future heart attacks or
strokes.

Mainstream Attention

Those results were strong enough for publication in the peer-reviewed CMAJ,
considered the 8th-most influential medical journal by impact factor,
an approximate measurement of a journal’s prestige. The journal added an
editorial saying
it expected pushback for the study but wanted to promote the project’s
scientific rigor. The publication has drawn attention from conventional
medicine along with the naturopathic world.

Sarah Speck, MD, MPH, FACC, a cardiologist at the Swedish Heart and
Vascular Institute in Seattle, says the study validates the naturopathic
approach of focusing on lifestyle changes before turning to
pharmaceuticals.

“Naturopathic medicine has a strong role in the prevention of heart
disease,” says Dr. Speck, medical director of cardiac rehabilitation and
prevention services at Swedish. “Since there is an epidemic of heart
disease, this study clearly shows the benefits of naturopathic medicine
should be more widely recognized and more widely used.”

Most doctors understand the importance of lifestyle changes to
improve nutrition, exercise and stress, says Dr. Speck. The challenge
for patients is figuring out how to make those changes — and make them
stick.

“The process of therapeutic lifestyle change is not easy, or we’d all
be thin and fit and not have any heart disease,” Dr. Speck says.

NDs, with their emphases on doctor-as-teacher and longer patient
visits (typically 30 to 90 minutes), are well-equipped to facilitate
those changes, she says.

Real-World Design

Lead investigator Dugald Seely, ND, FABNO,
director of research at the Canadian College of Naturopathic Medicine,
arranged the study with Canada Post, which has collaborated on past
studies on naturopathic care for back pain and anxiety. His research
team has been open about limitations of the study, many of which were
intentional.

For example, researchers did not tell doctors exactly what treatment
to provide, instead giving them a portfolio of naturopathic therapies
and leaving them room to customize the care for each patient. That made
it impossible to isolate exactly which therapies were most effective — a
task for future studies. In other words, the study doesn’t show whether
patients gained most by taking fiber supplements, learning how to eat
more vegetarian meals, having time to discuss anxiety, or another
therapy.

But the multipronged treatment regimen better resembles real-world naturopathic practice, says Dr. Bradley, who has helped develop new methods of patient-focused research.

“For studies to actually represent real practice, the intervention
needs to have multiple modalities,” he says. “Our research has
demonstrated that patients really can listen and change multiple
behaviors at the same time. They don’t get overwhelmed. In fact, they’re
eager to get information on how to reduce their own risk.”

The trial did not use methods or supplements that would be unfamiliar to NDs. That, too, is a strength of the study, says Jane Guiltinan, ND, dean of the School of Naturopathic Medicine at Bastyr University.

“It’s not anything we haven’t already been doing for a long time,”
she says. “The study should give naturopathic doctors more confidence
that their approach is effective. It adds to a growing evidence base
showing naturopathic medicine can be effective for reducing risk factors
for chronic diseases.”

Because the study measured naturopathic care alongside conventional
medicine, it lends support to more integrative partnerships, Dr. Seely
says.

“I think this shows that physicians in cardiovascular disease can see
naturopathic doctors as allies to provide better care for their
patients,” he says.

See the full study: Naturopathic medicine for the prevention of cardiovascular disease: a randomized clinical trial

From: Bastyr University News: http://www.bastyr.edu/news/general-news-home-page/2013/07/naturopathic-heart-care-brings-major-gains-study-canadian-postal