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From the Townsend Letter
October 2008

Comprehensive Lifestyle Intervention Improves Hair and Skin Status and Mental and Physical Functioning
by Gary Null, PhD, and Martin Feldman, MD

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The study found varying levels of improvement in the 20 measures of hair and skin condition that were rated. We also found improvements in the 22 aspects of mental, physical, and energy functioning rated by participants.

At the end of the six-month program, participants scored each outcome measure listed on our questionnaire as worse, unchanged, slightly improved, improved, or much improved. To simplify the presentation of data in this article, we have combined the three levels of improved condition—slightly improved, improved, and much improved—into one category in most of the charts included here (except Figure 1). What follows is a detailed look at the study results.

Hair and Skin Results
In Figure 1, we break down participants' ratings in eight of the 20 measures of hair, skin, and nail status into the five levels presented in our rating scale: worse, unchanged, slightly improved, improved, and much improved. As shown in the chart, participants' ratings tended to cluster in the "slightly improved" and "improved" categories.

Figure 1: Breakdown of Degree of Change Assessed in Eight Sample Hair and Skin Measures (78KB .pdf)

Figure 2 shows the percentages of participants who experienced change in the nine measures of hair status we listed. (As noted, the three levels of improvement listed in our questionnaire have been combined into one "improved" category in Figure 2 and all those that follow.) The two most frequently improved hair measures were thinning of hair (69.8% of participants) and hair texture (66.9%). More than half of participants also scored improvements in luster of hair (65.4%), balding (61.0%), graying of hair (58.3%), hair loss per day/week (57.3%), and darkening of hair color (52.6%).

Participants who scored "no change" in the nine hair measures ranged from 23.5% (thinning of hair) to 54.9% (eyebrows). Some participants rated three of the hair-status measures as "worse": thinning of hair (6.7%), hair loss per day/week (2.6%), and balding (2.0%).

Figure 2. Participants' Assessment of Change in Hair Condition (75KB .pdf)

Figure 3 shows the level of improvement in the seven measures of facial skin that we asked participants to rate. The two measures improved most often were skin texture (86.7%) and skin tone (81.2%). Also improved were acne when present upon entry (65.4%), wrinkles (63.0%), blemishes (61.4%), and eyelids (37.4%).

Figure 3. Participants' Assessment of Change in Facial Skin Condition (63KB .pdf)

Figure 4 shows the improvements found in four measures of body skin and nail condition: fingernails (66.9%), body skin (60.8%), toenails (59.9%), and neck skin (43.2%).

Figure 4. Participants' Assessment of Change in Body Skin and Nails (69KB .pdf)

Mental, Physical, and Energy Functioning Results
Participants' ratings documented a high frequency of improvement in mental capabilities and energy status, along with positive changes in many aspects of physical functioning.

Figure 5 shows that 91.5 % of participants rated their overall energy status as improved. There were improvements across the board in eight specific measures of energy functioning, including consistency of energy (90.8%), exercise endurance (88.6%), mood (86.2%), afternoon energy (83.3%), evening energy (81.9%), morning energy (81.8%), episodic changes (75.6%), and rest periods needed (67.7%).

Figure 5. Participants' Assessment of Change in Energy Function (63KB .pdf)

Figure 6 displays results in the physical functioning category. Of the eight outcome measures we specified in this area, the three that were improved most frequently were overall immune resistance (86.5%), a variety of other physical functions (78.1%), and sleep (67.0%). Also improved were overall joint function (66.7%), sugar reactions (65.2%), overall allergy condition (58.1%), pain (51.4%), and headaches (36.3%).

Figure 6. Participants' Assessment of Change in Physical Function (62KB .pdf)

As detailed in Figure 7, overall mental function was improved in 82.9% of participants. In the four specific measures of mental functioning that we listed, more than three-fourths said their memory (78.9%), attention span (76.5%), and clarity of thought (76.3%) had improved. Frequency of brain fog was improved in 64.2% of participants who were experiencing this problem upon entry to the program.

Figure 7. Participants' Assessment of Change in Mental Function (61KB .pdf)

Results by Gender and Age
Men and women had similar positive outcomes in our measures of hair, skin, and bodily functioning, as did participants in two age subsets: below age 55, and age 55 and older.

As shown in Figure 8, we compared mean scores for the two age subsets in our 20 measures of hair and skin condition. We found that participants under age 55 did significantly better (p value of .05 or less) than older participants in six of the 20 measures (acne, blemishes, skin tone, other skin change, body skin, and toenails). However, there was no significant difference in the age-related mean scores for the other 14 hair and skin measures. The younger participants also did significantly better in five of 22 measures of mental, physical, and energy functioning.

Figure 8. Differences in Assessment of Results by Age Group – Hair and Skin (38KB .pdf)

Similarly, Figure 9 shows a comparison of results for male and female participants. The mean scores of women were significantly better than men's in six of 20 hair and skin measures (balding, thinning of hair, other hair color change, texture of hair, hair loss per day/week, and neck skin). But there were no significant differences between women and men in the other 16 measures of hair and skin. Women also did better than men in six of 22 measures of mental, physical, and energy functioning.

Figure 9. Differences in Assessment of Results by Gender — Hair and Skin (38KB .pdf)

We believe that a multifactorial approach to lifestyle change is crucial to ameliorating damage to hair and skin. We also realize that a comprehensive approach requires substantial discipline and a willingness to surrender some unhealthy comforts. Hence, the need for more time and input in the self-empowerment component of the protocol.

The feedback we received is that the better people felt about themselves, the easier it was to sustain these rather severe lifestyle and behavioral changes. We also questioned more than 100 people who left the study early on, and they overwhelmingly complained that they did not have the discipline, self-confidence, or personal support system to see this program through. Therefore, our recommendation would be to work intensively for the first three months on improving self-esteem, gaining confidence, overcoming fear, and developing strength of character while educating people on the kind of lifestyle changes required by this intervention.

The final point to be made is that we have kept in contact with most of the people who completed the study. We have been encouraged to find that most are continuing with the protocols and seeing more improvements in all areas, although we have not measured those additional results. Despite the psychological hurdles to significant lifestyle changes, our findings suggest that the program's protocols are safe, nontoxic interventions that improve hair and skin status and overall wellness at far less cost than the treatments preferred by conventional medicine, including pharmaceuticals, plastic surgery, and other types of surgery.

Indeed, the greatest expense associated with this program was the cost of organic vegetarian foods for those who were able to obtain organic items. Generally, organic produce may cost 25% to 150% more than the same conventional items, depending on factors such as the specific food, the season, and the geographical area.53 (On the other hand, participants could save money by eliminating meat and junk food from the diet.) Participants also purchased certain appliances and environmental filters. Sample costs include: juicing machine ($180 to $360), water filter ($130 to $500), fluoride filter where needed ($70 to $100), chlorine shower filter ($40 to $65), and HEPA-grade air purifier ($180 to $500). Finally, some participants joined health clubs as well (national median monthly cost of membership for 2004: $5554; $60 to $100 per month in New York City). However, these expenses are minor compared with the cost of medications and health care treatments that may be needed by people who make unhealthy lifestyle choices.

On an individual level, the study has enormous implications for people who are not afraid to choose a more vigorous change in lifestyle and enjoy a healthy, happy, and fulfilled life. Extrapolating from this data would suggest that a wellness protocol could improve one's health or prevent diseases that we as a nation are ill-prepared to deal with constructively.
On a broader level, the findings suggest that a wellness model would be an invaluable addition to the preventive health care system in America. We are currently spending $2.2 trillion on disease but little to nothing on authentic prevention. We have a health care crisis in America. Health benefits for sick workers are a major cost to US corporations, and more than 47 million Americans have no or little health insurance. Patients who are self-empowered, as were the participants in this study, do not have to wait until there is a breakdown in bodily functioning to finally address their health. They can take greater responsibility for their well-being and help prevent such breakdowns from occurring.

Clearly we need a shift in perspective, and this study helps provide that. It is the first lifestyle intervention we know of that has studied the combined effects of the six lifestyle factors included in our program: nutrition, exercise, supplementation, stress management, behavioral change, and personal environment. We hope it will be used as the new standard for a comprehensive, high-quality health care intervention.

There were no financial sponsors of the "Hair and Skin Study." All of the lecturers, instructors, and medical supervisors donated their expertise at no cost.

Gary Null, PhD
2307 Broadway
New York, New York 10024 USA

Martin Feldman, MD
132 East 76th Street
New York, New York 10021 USA

Gary Null, PhD, has authored more than 60 books on health and nutrition and numerous articles published in research journals. He is Adjunct Professor, Graduate Studies, Public Health Curriculum, at Fairleigh Dickenson University in Teaneck, New Jersey. Null holds a PhD in human nutrition and public health science from the Union Graduate School.

Martin Feldman, MD, practices complementary medicine. He is an Assistant Clinical Professor of Neurology at the Mount Sinai School of Medicine in New York City.

"Hair and Skin Study"

Literature Citations on the Components of the Intervention

The "Hair and Skin Study" featured a primarily vegetarian diet. Fish was permitted as an optional food item because of its health benefits. Although studies on the benefits of nutrition have not focused on hair and skin, the literature supports the positive effect of vegetarian foods on human biochemistry and physiology.

Vegetarian Diet
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Appleby PN, Davey GK, Key TJ. Hypertension and blood pressure among meat eaters, fish eaters, vegetarians and vegans in EPIC-Oxford. Public Health Nutr. 2002;5(5):645-54.

Appleby PN, Thorogood M, Mann JI, Key TJ. Low body mass index in non-meat eaters: the possible roles of animal fat, dietary fibre and alcohol. Int J Obes Relat Metab Disord. 1998;22(5):454-60.

Bissoli L, Di Francesco V, Ballarin A, et al. Effect of vegetarian diet on homocysteine levels. Ann Nutr Metab. 2002;46(2):73-9.

Brants HA, Lowik MR, Westenbrink S, et al. Adequacy of a vegetarian diet at old age (Dutch Nutrition Surveillance System). J Am Coll Nutr. 1990;9(4):292-302.

Cade JE, Burley VJ, Greenwood DC. The UK Women's Cohort Study: comparison of vegetarians, fish-eaters and meat-eaters. Public Health Nutr. 2004;7(7):871-8.

Chang-Claude J, Frentzel Beyme R, Eilber U. Mortality pattern of German vegetarians after 11 years of follow-up. Epidemiology. 1992;3:395–401.

Chin JF, Lan SJ, Yang CY et al. Long-term vegetarian diet and bone mineral density in postmenopausal Taiwanese women. Calcif Tissue Int. 1997;60:245–259.

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Key TJ, Appleby PN, Rosell MS. Health effects of vegetarian and vegan diets.
Proc Nutr Soc. 2006;65(1):35-41. Review.

Krajcovicova-Kudlackova M, Simoncic R, Babinska K, Bederova A. Levels of lipid peroxidation and antioxidants in vegetarians. Eur J Epidemiol. 1995;11(2):207-11.

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Lowik MR, Schrijver J, Odink J, et al. Long-term effects of a vegetarian diet on the nutritional status of elderly people (Dutch Nutritional Surveillance System). J Am Coll Nutr. 1990;9:600–609.

Melby CL, Toohey ML, Cebrick J. Blood pressure and blood lipids among vegetarian, semivegetarian, and nonvegetarian African Americans. Am J Clin Nutr.1994;59(1):103-9.

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Nenonen MT, Helve TA, Rauma AL, Hanninen OO. Uncooked, lactobacilli-rich, vegan food and rheumatoid arthritis. Br J Rheumatol. 1998;37(3):274-81.

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Spencer EA, Appleby PN, Davey GK, Key TJ. Diet and body mass index in 38000 EPIC-Oxford meat-eaters, fish-eaters, vegetarians and vegans. Int J Obes Relat Metab Disord. 2003;27(6):728-34.

Szeto YT, Kwok TC, Benzie IF. Effects of a long-term vegetarian diet on biomarkers of antioxidant status and cardiovascular disease risk. Nutrition. 2004;20(10):863-6.

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