City ZeroHow Markets and Evolution save lives and money

Robb Wolf

Part 1: Economics & Moore’s Law

Diabetes: 2050

Where markets and technology meet

Quick Recap:When technology advances goods & services

improve, costs decrease.

We know more about biology, genetics and pathology than ever. But… Medical costs increase Quality of care decreases Disease rates increase

HOW can this possibly be So? What are we doing wrong?

On the Job Selection Pressure:Cops were dying

UNLV police officers 3 Cardiac events in 1 year

Costs to retire an officer-$1.2 Real costs 1ox this amount

Founded in 1993

Initially Orthopedic risk assessment

Could Metabolic risk assessment save lives (and money)?

In the BeginningStandard blood work

HDL, LDL, total chol, Trig’s

Framingham scores

American Heart Association diet

Results were dismal, often times worse than no intervention!

Paradigm ShiftLow Carb

National Lipid Association

NMR testing via Liposcience Labs

Current programYearly risk screening

High-risk individuals receive: Low Carb/Paleo* Targeted pharmaceuticals (statins**,

metformin***) Sleep counseling Exercise: metabolic conditioning

Pilot StudyNumber of participants 33

Program costs-$1000

Program savings 20/1 ROI $22million saved (prorated over 20 year

period)

That’s great, But…Are we STILL treating symptoms?

Is elevated LDL-P a symptom of intestinal permeability and systemic inflammation?

What is the mechanism of action for statins and metformin?

LDL is part of the Innate Immune Response!

Metformin improves insulin sensitivity AND prevents LPS toxicity

“The protective effects of the metformin treatment on the onset of fructose-induced non-alcoholic fatty liver disease (NAFLD) were associated with a protection against the loss of the tight junction proteins occludin and zonula occludens 1 in the duodenum of fructose-fed mice and the increased translocation of bacterial endotoxin found in mice only fed with fructose.”

“…Taken together, these data suggest that metformin not only protects the liver from the onset of fructose-induced NAFLD through mechanisms involving its direct effects on hepatic insulin signaling but rather through altering intestinal permeability and subsequently the endotoxin-dependent activation of hepatic Kupffer cells.”

Statins: Cholesterol Reduction or anti-inflammatory?

Addition of the Paleo Template

Intestinal permeability and autoimmunity

Integrating screening for: Intestinal permeability Autoimmunity

What’s nextProgram encompassing all Reno Police & Fire

With inclusion of paleo/AH models of inflammation

Spread program to global audience 45 Municipalities: Europe, AU, NZ, US

Consolidate data collection via Specialty Health

Release Health care provider education Gyms, allied HC, MD’s

Develop health insurance company pushing HSA’s and referral network to gyms, physicians & allied HCP’s

Epilogue: It’s all connected. And stuff.

Dedicated to the Next Generation