What is Volume 1 About?
The first volume of this book explores areas of modern physics with major implications for biology and medicine. Areas surveyed include thermodynamics applied to bioenergetics, quantum biology, complexity and chaos theories. Particularly useful is the notion of phase transitions sinceit reduces the number of variables in a complex system to the essential few. This has led to the introduction of order and control parameters with bifurcation points where instabilities built into such systems cause catastrophic changes in their behavior. In the context of human physiology, a bifurcation point is tantamount to the transition from health to disease. This powerful methodology has found applications beyond physics, e.g.in materials engineering, sociology, and even environmental science. A central theme connecting all chapters in Volume 1 is the importance of modern physics in gaining quantitative insights into biological systems. Modern physics offers an integrated representation of the hierarchical, interconnected, and synchronized organization of living matter.
A quantitative framework to describe the body’s responses to external stresses is proposed as a multi-dimensional fitness function analogous to the thermodynamic free energy. In volume 2, we refer to it as the Physiological Fitness Landscape (PFL) and tie this to the -omics generated Big Data analyzed by AI algorithms. Advances physics has made in understanding complex natural phenomena include areas such as quantum biology, which explained effects of electromagnetic fields on living systems (e.g. photosynthesis) and large-scale phenomena such as organism-wide synchronization through biological coherence. Of particular importance is the theory of quantum metabolism, which employs empirical quantization rules for mitochondrial enzymes analogously to the Debye theory of vibrations in solids. With mathematical elegance, quantum metabolism elucidated the origin of allometric scaling laws of physiology (relating metabolic ratesto body weight), a problem unresolved for over a century. Equally significant is the conclusion that inefficient energy production, characteristic of disease states (e.g.cancer) manifests isometric scaling laws (i.e. linear dependence of metabolic rate on body weight) while optimum states of health result from quantum metabolism’s synchronized energy production.
It is this author’s strongly held conviction that these multidisciplinary approaches support problem solving in clinical medicine, especially when integrated with Big Data and AI algorithms. This is the bridge to the bright future of medicine, which will be personalized, predictive, and precision-based.
What is Volume 2 About?
Volume 2 focuses on the metabolic basis for the development of chronic diseases of aging including diabetes, cardiovascular disease, dementias, and cancers through complex interactions of multiple parameters. We explore the intersections of the body’s stress response, the biology of time as mediated by molecular clocks and nuclear hormone receptors, changes in intestinal microbiota composition and diversity, insulin signaling and resistance, and mitochondrial function and malfunction. The interactions of these aspects are proposed as a model of the evolution of the chronic diseases of aging and promotion of health, termed the Physiological Fitness Landscape (PFL).
Circadian biology is defined as an elegantly orchestrated synchronization of metabolism, within and across tissues and organ systems. The PFL speaks to this exquisitely beautiful organization of metabolic features, which in an optimal state, reflects a synchronized precision of the human body. Chronic diseases cause spatial and temporal desynchronization of organ systems that interfere with energy production. As such there are three fundamental metabolic characteristics of the PFL that define “fitness”: redox, free energy, and acid-base balance. In the state of health, each is maintained within a narrow physiological range.
Volume 2 speaks to the transition from health to a disease state, which involves prolonged and/or exaggerated stress. Stress, a function of age and personal history may originate in the mind or body and shift metabolism out of balance. Stress drives a hormonal and autonomic nervous system response that originates from the brain and intersects with the immune system, gut microbiome, and insulin signaling and can be vastly exacerbated by redox-mediated inflammation. Uncontrolled redox causes local inflammation to spread throughout the body, lowers the thresholds for future stress responses and primes the body for exaggerated, chronic activation of the autonomic nervous system, kicking the hormonal branches of the neuroendocrine stress response into overdrive. Chronically, a prolonged stress response disrupts the natural circadian cycles of insulin secretion and signaling, which can cause pathological insulin resistance to ensue. Since insulin signaling is an important circadian regulator of clock-controlled rhythms, persistent hyperinsulinemia, a consequence of disrupted patterns of insulin secretion, promotes the loss of synchronized metabolism within and between tissues of the body. The stress response, deranged microbiota, disrupted redox, inflammation, insulin resistance and perturbation of molecular clocks/circadian biology all amplify one another in a vicious cycle, and physiological fitness therefore declines in a manner tantamount to the aging process.
Metabolisim & Medicine
About Dr. Brian Fertig
Brian Fertig is one of the nation’s leading endocrinologists with more than 35 years of practice in diabetes, endocrinology, and metabolism. As the founder and president of the Diabetes and Osteoporosis Center in Piscataway, New Jersey, Dr. Fertig’s passion for patient care and research led him to write a two-volume comprehensive book on metabolism and the human body, “Metabolism and Medicine.” Dr. Fertig’s poignant, informative monograph on metabolism is the definitive resource on metabolism and biophysical processes at all scales of the physiological journey. Based on Dr. Fertig’s clinical experience, research, and vision, Metabolism and Medicine integrates scientific disciplines of modern physics toward shaping and transforming healthcare. This consolidative approach to metabolism and its vital role in an individual’s daily life and evolution outlines metabolism’s role in aging and chronic illnesses, such as diabetes, cancer, Alzheimer’s, and heart and vascular diseases.
Written for healthcare practitioners, students, biomedical researchers, interested patients, and medicine enthusiasts, Dr. Fertig’s life work is encapsulated within the pages of each volume, where he conceptualizes his interdisciplinary insights and improves the skillsets for problem-solving and critical thinking in medicine. Dr. Fertig is sought out by members of the medical community and science communicators across multiple disciplines to collaborate and articulate his knowledge for a range of intended audiences – from physicians to scientists to patients and caregivers.
Understanding metabolism and how it affects your body is the first step toward managing many of today’s most complex diseases, including diabetes. Dr. Fertig deeply understands the underlying causes of Type 1, Type 2 and gestational diabetes, and works closely with patients to create a personalized treatment plan. These include treatment modalities, insulin injections or pump treatments, as well as dietary and lifestyle changes. He promotes a medical approach that takes insights from the world of physics, which he feels can help practitioners quantify therapies with precision. He combines physics and biology to offer an approach that blends the best of art and science.
Dr. Brian Fertig demonstrates an acute understanding of the human endocrine system based on clinical practice and research that translates into a dedicated and professional approach to patient care, helping his patients live healthier lives. As a practicing endocrinologist, Dr. Fertig leverages considerable experience with metabolic disorders and general health to guide patients through their diagnosis, optimize treatment protocols, and offer advice for managing the condition.
In addition to his private practice, Dr. Fertig channels his considerable knowledge into senior attending roles at Somerset Medical Center, Robert Wood Johnson University Hospital, and Hackensack Meridian Health’s JFK Medical Center. Dr. Fertig is currently Chairman of the Department of Diabetes & Endocrinology, Hackensack Meridian Health at JFK University Medical Center since 2010 and holds positions as clinical Associate Professor at Robert Wood Johnson Medical School and academic Associate Professor at Hackensack Meridian Health Medical School. Over the years, Dr. Fertig has also gained valuable expertise in education serving as both teaching and administrative chief resident at Englewood Hospital and Medical Center, where he also served as clinical instructor for The Mount Sinai School of Medicine. Through these positions, Dr. Fertig has instilled knowledge and teachings to medical students and residents from RWJMS, JFKUMC and Muhlenberg Regional Medical Center.
Patients and healthcare experts in globally can buy “Metabolism & Medicine,” through Amazon to learn how metabolic disruption can lead to disease.