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In Part One of my interview with Dr. Pizzorno, he explained the roles played by the immune, detoxification, and inflammatory systems. The rest of my interview with Dr. Pizzorno follows below.

Tell us about the metabolic system?

Dr. Pizzorno: That's primarily the digestive system, and here what we're talking about is the fact that there's not much value in eating healthy foods if you can't digest them. Maldigestion as manifested by things like hypochlorhydria (a diminished secretion of hydrochloric acid) is rampant in our society. For example, 80 percent of children with asthma have either no hydrochloric acid or very little hydrochloric acid in their stomach. Over the age of 60, the incidence of hypochlorhydria is about 50 percent. So I'm a great believer in making sure that there is enough hydrochloric acid being produced in the stomach.

Of course, the obvious question is why is hypochlorhydria so common. The primary reason that I can tell is because the trace mineral zinc that is necessary for the enzyme that produces hydrochloric acid in the stomach is so commonly deficient in our diets. The body simply can't make hydrochloric acid because it doesn't have enough zinc. So not only do I give people replacements of hydrochloric acid, I also make sure they have plenty of zinc in their diets so that they can start producing normal levels of hydrochloric acid.

What do you think is responsible for such a widespread incidence of hypochlorhydria in children?

Dr. Pizzorno: Very simple, I think it's their diet. If you look at the trace mineral content of our food, it's very low because of our modern agricultural procedures. In my book, I talk about the importance of eating organically versus commercially grown foods. If you look at the trace mineral content of organically grown food, you average about 50 percent more zinc in it and four times as much selenium. Deficiencies in both of these trace minerals are a huge problem in our society.

Other ways that we impair metabolic function are through the chronic overuse of antibiotics and antacids, eating excessively large meals, consuming high levels of sugar, fat, and refined foods, and neglecting to take a good multivitamin and mineral supplement. To improve digestion, I recommend taking herbal bitters with meals, supplementing with acidophilus once a day between meals, and taking one or two 10-grain tablets of betaine hydrochloride with pepsin with each meal.

Now we come to the regulatory systems. Here we're talking about the endocrine system, where the body's metabolic processes are controlled. The endocrine system oversees the sexual hormone levels, the levels of thyroid in the blood, the pituitary and the adrenal glands, DHEA secretion, and so forth. All of these things are crucial for proper health and function. Once again, as a result of lifestyle and dietary factors, these are seriously out of balance in our body.

One of the things that was a big revelation to me with regard to the regulatory systems is the importance of selenium. If you look at people's thyroid function and use thyroid hormone levels in the blood as a measure of thyroid function, depending upon what population group you examine, about 5 percent of the population is deficient in thyroid hormone. However, if you do functional tests of thyroid function, measuring basal body temperature, for example, which reflects how much thyroid activity is happening in the body, the percentage of the population that is functionally low in thyroid hormone goes up to 25 percent. Why is that? Why, if a person is low in thyroid, doesn't the pituitary just tell the thyroid gland to secrete more thyroid hormone?

The answer to that question is where the picture gets quite interesting. The pituitary secretes a hormone called T4 that goes into the blood and into the cells. Now T4 is metabolically not very active. However, when T4 is converted by the cells into T3, you have a hormone that is four times as active as T4. In other words, it's the action of T3 that is actually metabolically active in the body. But in order to convert T4 into T3 the body requires adequate levels of selenium. I just mentioned that selenium is a commonly deficient trace mineral in our diets today. So what happens is that our bodies are not able to make this necessary conversion.

What is a good food source of selenium?

Dr. Pizzorno: Unshelled Brazil nuts are a very rich source of selenium, but they have to be in shell. This is just a quirk, but the Brazil nuts which go to the shelling factories in South America happen to have a lower level of selenium in them than those that are unshelled. Eating half a handful of unshelled Brazil nuts a day will provide adequate amounts of selenium.

For people who live in areas where they can't get Brazil nuts, what dosage range of a selenium supplement do you recommend?

Dr. Pizzorno: The typical dose is 200 micrograms of selenium a day, either alone or as part of a multivitamin formula. Notice, that's micrograms, not milligrams.

To conclude this section on the regulatory systems, I want to also recommend avoiding refined and commercially grown foods, alcohol, and smoking, and to ensure against habitual physical or emotional stress.

Which brings us to the regenerative system?

Dr. Pizzorno: Yes, the body has a very effective system for repairing and replacing damaged tissues. However, we have to do certain things to make sure this happens. I hate to say this, because this is an area where I have my own personal greatest difficulty, but one of the key elements for rejuvenation and regeneration is adequate sleep. It's while we are sleeping that the body's regenerative processes are at work. But in our society today, adequate sleep is becoming lost. If you look at the amount of sleep we get now compared to our grandparents at the turn of the century, we are averaging almost two hours less sleep a night than we got 100 years ago.

What was the average amount of sleep 100 years ago?

Dr. Pizzorno: Nine hours at the turn of the century. And today we're averaging about six or seven hours.

That's about where I'm at.

Dr. Pizzorno: Me too, and I know it's not good. Obviously there is substantial individual personal variation, but the bottom line is that we're sleeping a lot less now than we did in the past. And even when we are getting the sleep, we aren't sleeping as deeply. We're sleeping later at night and bypassing the normal circadian rhythm that's created by nature.

In your chapter on regeneration, you also talk about the musculoskeletal system. What tips would you suggest for keeping it in order?

Dr. Pizzorno: Use it or lose it. The only reason older people are weaker than younger people is because they get less physical activity. I think this is very straightforward.

What kind of exercises do you recommend people engage in?

Dr. Pizzorno: I'm a great believer in Super Slow, a form of weight-lifting that is a very efficient way of building muscle mass with minimum time investment. It's high intensity, short duration. Instead of a large number of repetitions, three cycles of a dozen reps each, for example, Super Slow emphasizes very slow movement - a count of ten up and five down - while holding a weight heavy enough to cause total muscle exhaustion after the sixth rep. So you do a shorter number of reps over a very short period of time, yet it's extremely effective. Doing Super Slow once a week, I've increased my strength with only 20 minutes of workout. It's very, very efficient.

Now, I'm physically very active. I play a lot of basketball, so I feel very strongly about aerobic exercise, as well. But I also think strength training is very important. Walking and jogging are also valuable, but people who do a lot of jogging should be sure to wear proper gear and do it in a proper location. I see a lot of joint disease among people who do a lot of jogging without proper gear, due to its high impact on the joints.

OK, this brings us to what I think is really the most often overlooked aspect of our health, the mental and spiritual component.

Dr. Pizzorno: That's the one I feel least qualified to talk about (laughing) which is why I asked my wife Lara to write that section of Total Wellness. As a clinician I have seen so clearly that people have reasons for being sick, and so often these reasons are directly associated with a lack of value or a lack of understanding in their lives. Many of these people also fit the profile of the Type A personality. They are often on the run and rarely relax, have few friendships, and lack anyone to whom they can turn for support. They also fail to take time to connect with nature in some regular way, and lack a commitment to higher, spiritual values. I don't really care what methodology a person uses to address these issues, but the bottom line is that at some point all of us must address the reason for our existence. There are a lot of pathways to do that; what's vital is that we pick the one that suits us and stick with it.

As I said, I'm not an authority in this area, but some of the things I recommend are to prioritize what's important to you and then start living according to your values, to regularly take time each day to spend with your loved ones, and to meditate or pray. Developing a hobby that puts you in contact with nature, such as gardening or walking outdoors, can also be helpful, as can joining a church, synagogue, or other group that provides spiritual and social support. Focusing on what you have to be thankful for and giving thanks daily is also important. And as I wrote in my book, whenever you have the opportunity to be kind or helpful, grab it!

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