We introduced the concept of “diagnosis” in the previous episode and now it’s time to fully unpack it. In the simplest of terms, a diagnostic test tells you if you are diseased. But chronic disease and acute disease are two VERY different things. We’ll explain why, plus we’ll talk about an even more powerful fact: for the first time in human history, we have access to tools that can help us understand our bodies in ways never before possible.
James Maskell: 00:06 Hello and welcome back to the Big Bold Health Podcast. We are making health personal in a world of disease. I’m back here with my co-host, Dr. Jeffrey Bland, welcome doc.
Jeffrey Bland: 00:17 Wonderful to be back on this topic. Thank you.
James Maskell: 00:19 So, we’re gonna talk a little bit about disease today, and I have in front of me what I used to refer to as the pinnacle of your career. Now, obviously, it’s the Big Bold Health Podcast, cause that’s clearly the best thing ever. But this is, The Disease Delusion by Dr. Jeffrey Bland, and it was really the first book I read of yours that sort of gave me a context of what you were all about.
The Disease Delusion is a punchy title. I’m a big fan of punchy titles as a Brit as well, so tell me a little bit about who came up with this title.
Jeffrey Bland: 00:50 You know, after I got the concept of the book, I shared this thought of this title with my publicist and then later the publisher, and they thought, “Well, no, that’s really- it seems like it’s too contradictory. There are diseases, and this is kind of like an oxymoron.” And I said, “That’s true, it is, because yes there are diseases, but we’re delusional about where they came from and how they have manifested themselves over time.”
What we call a disease today is very different than that same set of symptoms would have been called maybe years before. And, in fact a good friend and colleague, Dr. Robert Sapolsky, who is a neuro endocrinologist of world fame at Stanford wrote a book called, Why Zebras Don’t Get Ulcers, and another book called, The Trouble With Testosterone, in which he was talking about stress and its influence on our health. And, he made a very interesting comment in that book, he said, “Do you realize that the way people feel crummy over time stays the same?” They might even say, “I got a headache, or I got shoulder pain, or I got a stomach pain, or I’ve got bleeding, or whatever it might be.”
So, that crumminess stays the same, but what we call it over time has changed. So, the convention of disease changes, the concept of what’s happening in our body stays the same. So why then, do we call the book, The Disease Delusion? Because, I want people to get away from the feeling that if they get a disease, that it’s somehow a consequence of them having some flaw, or they got the bad luck of the draw with their genes. They didn’t even fill out an application card, they just got whatever their parents gave them, and woe is them if their father had heart disease or their mother had breast cancer, or whatever it might be, because that was their lot in life.
And, what I want people to recognize is, no, that’s a delusional concept that is not really matched up with what we now recognize: that our genes don’t give us diseases. Our genes give us our function, and our function is related to how our genes are influenced by our lifestyle—how we eat, how we live, how we think, and our environment, and therefore if we really want to push back and look at health, not disease, we need to take charge of the things that are modifiable, which are not whether we’re taking a drug or not, it’s how we’re living.
James Maskell: 03:09 So, I understand cause this exact topic gets to the crux of the Big Bold Health Podcast, in my mind, is that we’re talking about health through the lens of disease, and therefore get all scrambled as to what the concepts are. Can you give some examples of things that you’ve heard in the past, even words that are used that are contradictory through this lens?
Jeffrey Bland: 03:33 Yeah, I think it is very interesting, James, even in our field of health promotion and disease prevention, people will often talk about, “what is the diagnosis?” when they have a certain test done. What is the diagnosis? Once you use the word diagnosis, you’re not looking at where you’re going, you look at where you’ve been. A diagnostic test tells you if you’re diseased. It doesn’t tell you how you’re functioning going forward. That would be a prognostic test, right? It’s forward-looking.
So, what we need to start changing is our language about how we see ourselves as it relates to our health, not our disease. And I’ve often thought, you know, people say, “Well, I want to prevent disease.” Well, the only way you can really measure prevention of disease is how you’re functioning in the moment. Do you feel well? Do you have ability to do the things that you wanna do? Are you thinking clearly? Do you wake up feeling vitalized in the morning. Are you able to carry out the work that you want to do? Do you enjoy life? Are you feeling the community of support? Do you feel like your life is purposeful?
Those are aspects of health, not do you carry a risk factor to a disease? So, I think that we are really reframing, in the Big Bold Health, the whole construct of let’s stand up for a different standard. Not skirting around the edges of life hoping our number doesn’t get pulled so we don’t get a disease, but our advocacy as individuals who can be bright lights of good health by just standing tall in the area of our lifestyle, doing the things our genes need us to do to be in optimal function.
James Maskell: 05:15 It’s so interesting you say that because I’ve literally spent most of the last year trying to convince people that there could be a different way of managing disease risk, right? and traditionally that’s been done by insurance. I think that cost-sharing is an interesting way of doing it. But, it is interesting how even people who are schooled in health creation, the mindset always goes towards fear and risk. Why is that such a hard concept to just get away from?
Jeffrey Bland: 05:48 I think there are a couple of reasons for that, one of which is when you are diseased, there are rules that have been set up within the medical system to give you a name that you can wear, and you can tell people, “Well, I feel badly because I have type two diabetes.” And now, you suddenly wear something that you can define clearly. It also leads to a triggering of a series of events that lead to a reimbursement of services, that’s called the insurance plan. It also leads you into the disease care system—it’s a library card that gets you into the disease car system. And you now become part of a club, and that club is that you’re flawed, you’re injured, you’re not perfect, and you are a victim looking for a rescue.
When you’re a victim for a rescue, you either feel like, “Well, I’m in a class of other people who are victims that are looking for rescue.” Or you say, “You know, I don’t really wanna be a victim, I wanna be in charge, and I want to be an advocate for myself,” which then takes you out into another please which is really this health promotion concept. It’s not just skirting around the edges and being a victim and hoping that somebody when you’re on bended knees will give you the right prescription.
And in fact, as we’ve talked about, you and I, this whole concept of a prescription pill solution to a problem has a very significant limiting effect. We know because, if you examine any disease and treatment by the drug that’s approved for that disease, what you find in a class of people who have that disease, it may only find that one of every fifteen people with that disease really has a positive response to that drug. Even though it’s approved by the Food & Drug Administration, when you actually look at the data you don’t find very strong support for high success rates.
James Maskell: 07:35 So, two years ago I went to a conference that you put on, and there was a guy called Dr. Leroy Heard who is from this area. He put up that slide, and it showed exactly what you’re talking about which is, for the most common drugs—I think it is the most ten used drugs—how many people does it not work for, for the people that it does? And, I took a picture of that slide, and I show that picture to a lot of people, because I don’t think people really have an idea that this is happening, that that’s the way it is.
And, when it was there in yellow and blue, not in black and white but clearly in yellow and blue, for every yellow person there are five blue people, or ten blue people, or in some cases twenty-four blue people who it doesn’t work for, it’s a shocking revelation to most people.
Jeffrey Bland: 08:23 Okay, so now the question is, I’ll come back to you: why is that? And that’s why I call the book, The Disease Delusion, because it’s assumed that everybody with that disease has the same thing going on, so that one pill will work for all. It’s a class effect, right? But actually, now it’s been found out that if you examine a hundred type-two diabetics, you have a hundred variations on a theme. It’s not just this one disease, it’s multifaceted.
Why is it that there are fourteen different drugs approved now for type-two diabetes? If it was one disease, one pill should work, shouldn’t it? So, what we’re seeing is we are all individual in the way that we respond to our lifestyles, our environments, our diets. And, if we can turn this thing around from looking at ourselves as a part of a class, a group, to looking at us as individuals—that’s why personalization is the age of the twenty-first century.
James Maskell: 09:17 You know what, what it makes me think of is probably one of the areas that we’re both involved in that is the most exciting in terms of big bold health, is the reversal of mild cognitive impairment and Alzheimer’s. And, that disease is just like type-two diabetes, that is just like all of these diseases, where different things work for different people, because the etiology—the cause of what’s causing this disease—is different in different people, and if you don’t treat the cause then you never get to the solution.
I mean I think it’s an ingrained-ness, there’s certainly a deference to authority where it’s like, “I’m not trained as a physician, I don’t know anything about this. This person knows, I’m just gonna do what they say.” That’s kind of the shift that’s happening to, is that there’s a shift from the doctor is the one with the bag of tricks, to the patient, actually, with the incredible bag of tricks that we all have inside of us.
Jeffrey Bland: 10:11 So, here it comes. Now we’re on the intersection to the paradigm revolution. This is the Big Bold Health, now, you’ve just stated. Because, for the first time in human history, we are developing and have access fairly inexpensively to tools to understand our bodies in ways that even no physician ever understood.
I just brought a few of those tools as an example that demonstrate how we are developing a logical understanding of our bodies in ways that people never had access to.
James Maskell: 10:43 Well, let’s start with this one, and for those of you listening at home, I am pulling out a FreeStyle Libre. So, this is a continuous blood sugar monitor. Tell us about how this thing does what you just said.
Jeffrey Bland: 10:57 So, that is actually one of two different systems. Here is another one I would show you, it’s called the Dexcom. So, these are now available, you can buy them over the internet, they’re devices that go onto your skin that are measuring continuously your blood sugar level.
Now, why is that of any interest?
James Maskell: 11:16 It’s not disease.
Jeffrey Bland: 11:18 Exactly, it’s not disease. So, think of the way that we have known about our blood glucose or blood sugar levels historically. We go to the doctor, whatever your routine, frequency of having your blood test done. If they think that you’re in a certain category they will give you what’s called a blood panel. In that blood panel is blood sugar, blood glucose, that’s one of the things, and it’s measured one time, maybe once a year—most people maybe don’t even go to the doctor once a year—and it’s measured after you’ve been fasting, under whatever conditions preceded that. Maybe you were on vacation before, maybe you had a party the night before, maybe, I mean, it could be all sorts of different things.
James Maskell: 11:53 Maybe you had a secret ice cream on the way to the doctor’s?
Jeffrey Bland: 11:55 Well, hopefully not, because you should be fasting, but the bottom line is, you have one data point from which you’re making a decision—do you have the disease diabetes or not?
Okay, now, just a second, hold that for a moment. What would happen if you had a hundred measurements of your blood sugar over a day that were related to everything you were doing? How you were eating, thinking, moving, how you were drinking your fluids, how you were under stress, and you could—with all those measurements throughout the whole day—see the mountain ranges of how your blood sugar was going up and down relative to your lifestyle. And, you would start to see, “Oh, my word, I never recognized it, when I had an argument with my child that my blood sugar went into the diabetic range. I never recognized it when I had work stress, that my blood sugar was so low that I was in hypoglycemia.”
This is a knowledge of yourself that no doctor has ever had in the history of medicine.
James Maskell: 12:54 It’s so interesting you give those lifestyle examples, because I know people who have worn these, right, cause we’re all in this world, and the feedback that they give to me is that even though they know themselves and they’ve lived in their own body, they have no idea. So, they thought it would be one food, but it was another food. They thought that it would be just food, but then if they go for a walk after the food, it goes away.
But, what’s been really interesting is I know people who are literally obsessed with food, it’s their whole career. They’re educating on it, they’re teaching on it, that’s it. And yet food is not the biggest mover for them. It’s the stress and it’s the family stuff, and the things that get in the moment.
And, to have that data all the time is super interesting because, as you said, when you go to that doctor one time, you have no idea of the context of where they’ve just been. They’ve probably just driven there in traffic.
Jeffrey Bland: 13:43 So, the doctor is going to tell you you’re healthy because you don’t have diabetes, so it’s the absence of disease. The continuous blood sugar monitoring is gonna tell you how you’re functioning, which is related to your health. One is disease, one is health.
Now let me give you my own example. This was an ah-ha for me. Now, I’ve been measuring my blood sugar. I’m a registered clinical biochemist, so I’ve been measuring it for over forty-five years routinely. And, I’m not diabetic, I have healthy blood sugar, but when I started doing continuous blood sugar monitoring, what did I find? I found that my highest level of blood sugar was occurring at five o’clock in the morning.
Now I don’t eat at five o’clock in the morning. I’m waking up at five o’clock in the morning. Where does my blood sugar come from if I’m not eating early in the morning? It comes from the fact that my sugar, which has been stored in my body as glycogen, is being released in preparation for the day, because my nervous system is already revving up to get ready for the day. Right? So, my blood sugar goes up to the highest level throughout the whole of the day, is at five to six o’clock in the morning.
Now, what does that tell me about my nervous system? It says me I’m a hot reactor. Well, I know that from my personality, but it duplicates that by saying I’m the person who takes environmental stimuli and translates it into function very rapidly, which means I better be careful, because that could either be a skill or a liability. It can turn you on to be very productive, but it can also burn you out.
So, you start learning something about yourself that you never knew by just taking one blood sugar measurement a year on your blood test.
James Maskell: 15:16 Well, let me go further into that, because I wanna talk about the financial implications of just this knowledge that you’ve shared. It seems to me that as the medical system, or as this health creation structure shifts from disease care to health, there’s no professional that can ever know you as well as you know yourself with this kind of information. And, the externalization of the responsibility is the most costly thing that we may have ever done as a species.
Jeffrey Bland: 15:48 Yes, yes and so how do we make this user friendly? Because we don’t wanna convert everybody into a quantified human, which they have to become an expert and take post-graduate training on how to measure themselves, but we now have, as you know, thanks to the Cloud, we have ways of taking all this data that comes out of continuous blood sugar monitoring, our pulse, our sleep cycles, and sending that up to an information base in the Cloud that can be analyzed and sent back to us on our smart devices saying, “Here’s an interpretation of what you’ve just learned about yourself over the last twenty-four hours.”
Let me give you an example, here’s another little tool that I’ve been using that I think is really important. This is one of many, it’s a heart rate variability monitor. So, it straps on, it’s another monitor that can go around, so it can measure not only your heart rate, but it measures the kind of EKG pin, electrochemical potential of your heart, that tells you about the variability of your heart rhythm.
Now, it turns out the variability of your heart rhythm is very closely related to your overall health patterns. If you have a very rigid heart rhythm, you don’t have this fine structure of variability, it means you’re not really very as fit, you don’t have as much resiliency. And, you can change your heart rate variability by appropriate training, personalized intervention. I don’t mean just exercise training, I mean stress management, I mean diet, I mean proper sleep. You can change your heart rate variability so that the combination of your continuous blood sugar monitoring, your heart rate variability, now what are you becoming?
You’re becoming the master of your own body by knowledge. This is where we’re heading right now. This is a revolution in health care, not disease care, in health care. The doctor who’s strictly focused on disease care, this is just a distraction to them, cause they don’t even know what to do with this information.
James Maskell: 17:34 Expecting a doctor to interpret the information from your wearable is not a plan. This is not the way things are going because these two things don’t interact.
I wore an Oura ring this summer, for the summer, and the thing that I learned was that there were things in the way I interpreted my own health that were qualitative enough that I didn’t really know what was going on. So, what I found is that, how do you sleep? So, the Oura Ring measures that heart rate variability, but also sleep. And, what I know about myself is that I sleep well, quote-unquote, and that when it’s time to go to sleep, I go to sleep, when it’s time to wake up, I wake up, and nothing else really too dramatic happens in the meantime.
And, so I’m a good sleeper. When I put on the Oura Ring, what I realized is that although those two things were true, in those ways my scoring was good, my level of deep sleep, the percentage of sleep that was actually seriously restful was very low. And so, how would I ever have known that? There’s no way that I could know that.
And so, by having this information it actually led me to change some behavior, like, everyone was right, I probably shouldn’t be looking at my phone last thing at night. Don’t have the phone in the bedroom, deep sleep percentage goes up. There’s no way that I would have known that just with understanding my own physiology and understanding myself, but this external device kind of helped me to really understand myself better, to be able to self-regulate.
And, I think that’s sort of the difference of where we’re going to where we’ve been is that one, I’m in charge, two, I’m learning things about myself that are important for me and me only, and three, that there’s no medicalization at all.
Jeffrey Bland: 19:19 Well, these are revolutionary concepts. Let’s use a very simple one that you and I are familiar with, I think most people are, and that’s heart rate. Not heart rate variability, just heart rate. Resting heart rate—how many beats per minute—which you can measure on your pulse or have a device to do it, there are a lot of new smart devices that will do that.
So, what does that have to do with anything of your function? It doesn’t tell you if you’re diseased, but it does tell you how your cardiovascular heart and blood system are functioning, your arteries. Elevated heart rate is one of the great predictors of later-stage problems, not just heart disease but other problems that relate to age-related disease.
So, what can you do to influence your resting heart rate? Let me give you an example. When I was doing this, mine usually runs around fifty-six beats per minute. That’s my normal resting heartbeat. When I went to Hawaii and I had my device on, and I went on vacation, I went surfing every day with my buddies, and I was living this kind of relaxed environment, my mean average resting heart rate went to forty-six beats per minute. Ten beats less, or nearly a twenty-five percent reduction in my cardiovascular heart rate.
So, what does that mean? That means I put functional reserve—I learned that stress management for me was a very powerful feature of what I should be focusing on if I want to personalize my health program. Not my disease program, my health program.
You put that together with the fact that my blood sugar is highest at five in the morning cause I’m a hot reactor, so what’s that telling me about myself? It’s interrogating, and leading to knowledge, and knowledge is power, knowledge is control. And now we become self-efficacious. What does that mean? We become in control. We become the master of our own universe. We’re not dependent on others to tell us whether we’re sick and need a pill, we’re controlling our function, which is the most dramatically important thing that we’ll ever own, is our function over the course of living.
James Maskell: 21:17 Let me take this out five or ten years, cause this shift is happening right now. This thing, this FreeStyle Libre, you have to buy it online because you need a prescription, but I know there’s gonna be ones that are gonna come out for the consumer.
Let’s talk about what the health system looks like in 2025. Six, seven years down the road, what does that look like as far as the consumer. What I see is you have all of this data about yourself, you’re not connected to the medical system, all of this information is coming in. I imagine some sort of Alexa type of thing in your house where you have a readout of all these numbers, and it’s not just continuous blood glucose, there’s all these other things that are being measured, and potentially a meal is being created that is to get you back to homeostasis. It’s reminding you of your stress management routine, “It’s about time to go on a holiday to Hawaii, you’re overdue.”
Give us a picture of what that looks like, cause I think a lot of people need to get their head around where this is going to understand where it is now.
Jeffrey Bland: 22:27 I don’t even think we need to go out to 2025 to see where it’s going. Let me give an example, perfectly in line with what you’re talking about.
The company Nutrino was just acquired-
James Maskell: 22:39 By Medtronic, right?
Jeffrey Bland: 22:40 By Medtronic. Now, why Medtronic? Medtronic is a company that makes pacemakers and develops cardiovascular resuscitation equipment. Why would they be interested in Nutrino?
Nutrino is an app that has over fifteen thousand food compositions that are built into that app that tie directly to the control of blood sugar, and the Nutrino app is tied to your continuous blood sugar monitoring device. And, it will tell you exactly—you can take a picture of your foods in the restaurant, or at the grocery store, or wherever, in the home, and it will tell you whether that food is feeding into your Libre so that it controls your blood sugar correctly.
Do you get where we’re going?
James Maskell: 23:21 The building blocks of what we talked about.
Jeffrey Bland: 23:23 That’s exactly right. So, the person takes their smart device, they hold it up in front of their plate of food, take a photograph. Nutrino, then, the app, analyzes and says, “You know, really that’s too much potatoes on your diet for your blood sugar and you’re gonna have way more high blood sugar than you really wanted, therefore you need to cut that down and replace it with this.”
It becomes your in-home slave, for being your coach and being your expert to analyze your information and personalize it. We are moving right now into an era of personalization. Remember, that we have been through nearly six decades of the concept that you are part of a group, you are a statistical number in a population of people that could be defined as any other person in your group. And, now what we are recognizing is the differences among people in a group is greater than the difference among groups.
James Maskell: 24:22 Isn’t that an incredible lesson for humanity?
Jeffrey Bland: 24:28 And, let me take it to another level. In the “New England Journal of Medicine,” presumably one of the top medical journals, just this last year was an article entitled, “The End of Race.”
Now, what was that article all about? The article was about the fact that in medicine, we segment out different therapies for people with their different ethnicities. So, a different ethnicity might have a different dose of a certain drug, or a different kind of drug based upon their race.
And, what they’ve now found out from genomic testing is that the variation among differences within a specific race is greater again than the difference in the average among the races. So, there really is no such thing as race.
You might say it, “Well, that presents a different skin color, eye color, hair color, or something,” but at the physiological level, we are all uniquely different. We’re homogenized and we’re different.
James Maskell: 25:23 So, thirteen years ago I came and worked in this world because I felt like health was gonna be a transformational topic that might help to deal with some of the big issues of our time as a race. And, can you just see that what you just said there is incredible, because it makes me feel like I came in the right place at the right time, because ultimately we are dealing with much bigger issues than the cost of chronic disease, even though that might be the biggest and most vexing problem.
And it’s super exciting to see that this shift from disease care to health care might have a knock-on effect—will have a knock-on effect—that will permeate all these different areas that look like really unsolvable problems.
We have a lot of really unsolvable political, economic, ecological problems and my feeling is, and my sort of gut-instinct that my microbes have been alerting me to is that this transformation that we’re cataloging in the Big Bold Health Podcast from disease care to health care, is a catalyst for the transformation of human consciousness.
Jeffrey Bland: 26:33 Absolutely. I think maybe the transformation, as much it is the manifestation of this transformation. So, this to me is the reason for being, it’s why the Big Bold Health Podcast exists. Health is a very intimate thing, we’re all concerned about it, but it’s an entry point into self-discovery and to creating the human that we all want to be.
James Maskell: 26:54 Well, I’m excited for the next few episodes. I think this is gonna be a great journey. I’m so thankful to have this opportunity to look at all these tech gizmos, and to spend this time with you, and to really be charting this journey.
Thanks so much everyone for watching and listening at home. It’s been a pleasure to be here on the Big Bold Health Podcast with you, Dr. Bland. I’m James Maskell and we’ll see you next time.
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You acknowledge that COMPANY has the right but not the obligation to use and display any postings or contributions of any kind and that COMPANY may elect to cease the use and display of any such materials (or any portion thereof), at any time for any reason whatsoever.
Limitations on Linking and Framing. You may establish a hypertext link to the Site so long as the link does not state or imply any sponsorship of your site by us or by the Site. However, you may not, without our prior written permission, frame or inline link any of the content of the Site, or incorporate into another website or other service any of our material, content or intellectual property.
Disclaimers
Throughout the Site, we may provide links and pointers to Internet sites maintained by third parties. Our linking to such third-party sites does not imply an endorsement or sponsorship of such sites, or the information, products or services offered on or through the sites. In addition, neither we nor affiliates operate or control in any respect any information, products or services that third parties may provide on or through the Site or on websites linked to by us on the Site.
If applicable, any opinions, advice, statements, services, offers, or other information or content expressed or made available by third parties, including information providers, are those of the respective authors or distributors, and not COMPANY. Neither COMPANY nor any third-party provider of information guarantees the accuracy, completeness, or usefulness of any content. Furthermore, COMPANY neither endorses nor is responsible for the accuracy and reliability of any opinion, advice, or statement made on any of the Sites by anyone other than an authorized COMPANY representative while acting in his/her official capacity.
THE INFORMATION, PRODUCTS AND SERVICES OFFERED ON OR THROUGH THE SITE AND BY COMPANY AND ANY THIRD-PARTY SITES ARE PROVIDED “AS IS” AND WITHOUT WARRANTIES OF ANY KIND EITHER EXPRESS OR IMPLIED. TO THE FULLEST EXTENT PERMISSIBLE PURSUANT TO APPLICABLE LAW, WE DISCLAIM ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. WE DO NOT WARRANT THAT THE SITE OR ANY OF ITS FUNCTIONS WILL BE UNINTERRUPTED OR ERROR-FREE, THAT DEFECTS WILL BE CORRECTED, OR THAT ANY PART OF THIS SITE, INCLUDING BULLETIN BOARDS, OR THE SERVERS THAT MAKE IT AVAILABLE, ARE FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS.
WE DO NOT WARRANT OR MAKE ANY REPRESENTATIONS REGARDING THE USE OR THE RESULTS OF THE USE OF THE SITE OR MATERIALS ON THIS SITE OR ON THIRD-PARTY SITES IN TERMS OF THEIR CORRECTNESS, ACCURACY, TIMELINESS, RELIABILITY OR OTHERWISE.
You agree at all times to defend, indemnify and hold harmless COMPANY its affiliates, their successors, transferees, assignees and licensees and their respective parent and subsidiary companies, agents, associates, officers, directors, shareholders and employees of each from and against any and all claims, causes of action, damages, liabilities, costs and expenses, including legal fees and expenses, arising out of or related to your breach of any obligation, warranty, representation or covenant set forth herein.
Online Commerce
Certain sections of the Site may allow you to purchase many different types of products and services online that are provided by third parties. We are not responsible for the quality, accuracy, timeliness, reliability or any other aspect of these products and services. If you make a purchase from a merchant on the Site or on a site linked to by the Site, the information obtained during your visit to that merchant’s online store or site, and the information that you give as part of the transaction, such as your credit card number and contact information, may be collected by both the merchant and us. A merchant may have privacy and data collection practices that are different from ours. We have no responsibility or liability for these independent policies. In addition, when you purchase products or services on or through the Site, you may be subject to additional terms and conditions that specifically apply to your purchase or use of such products or services. For more information regarding a merchant, its online store, its privacy policies, and/or any additional terms and conditions that may apply, visit that merchant’s website and click on its information links or contact the merchant directly. You release us and our affiliates from any damages that you incur, and agree not to assert any claims against us or them, arising from your purchase or use of any products or services made available by third parties through the Site.
Your participation, correspondence or business dealings with any third party found on or through our Site, regarding payment and delivery of specific goods and services, and any other terms, conditions, representations or warranties associated with such dealings, are solely between you and such third party. You agree that COMPANY shall not be responsible or liable for any loss, damage, or other matters of any sort incurred as the result of such dealings.
You agree to be financially responsible for all purchases made by you or someone acting on your behalf through the Site. You agree to use the Site and to purchase services or products through the Site for legitimate, non-commercial purposes only. You also agree not to make any purchases for speculative, false or fraudulent purposes or for the purpose of anticipating demand for a particular product or service. You agree to only purchase goods or services for yourself or for another person for whom you are legally permitted to do so. When making a purchase for a third party that requires you to submit the third party’s personal information to us or a merchant, you represent that you have obtained the express consent of such third party to provide such third party’s personal information.
Interactive Features
This Site may include a variety of features, such as bulletin boards, web logs, chat rooms, and email services, which allow feedback to us and real-time interaction between users, and other features which allow users to communicate with others. Responsibility for what is posted on bulletin boards, web logs, chat rooms, and other public posting areas on the Site, or sent via any email services on the Site, lies with each user – you alone are responsible for the material you post or send. We do not control the messages, information or files that you or others may provide through the Site. It is a condition of your use of the Site that you do not:
COMPANY may host message boards, chats and other private/public forums on its Sites and on other platforms. Any user failing to comply with the terms and conditions of this Agreement may be expelled from and refused continued access to, the message boards, groups, chats or other such forums in the future. COMPANY or its designated agents may remove or alter any user-created content at any time for any reason. Message boards, chats and other public forums are intended to serve as discussion centers for users and subscribers. Information and content posted within these public forums may be provided by COMPANY staff, COMPANY’s outside contributors, or by users not connected with COMPANY, some of whom may employ anonymous user names. COMPANY expressly disclaims all responsibility and endorsement and makes no representation as to the validity of any opinion, advice, information or statement made or displayed in these forums by third parties, nor are we responsible for any errors or omissions in such postings, or for hyperlinks embedded in any messages. Under no circumstances will we, our affiliates, suppliers or agents be liable for any loss or damage caused by your reliance on information obtained through these forums. The opinions expressed in these forums are solely the opinions of the participants, and do not reflect the opinions of COMPANY or any of its subsidiaries or affiliates.
COMPANY has no obligation whatsoever to monitor any of the content or postings on the message boards, chat rooms or other public forums on the Sites. However, you acknowledge and agree that we have the absolute right to monitor the same at our sole discretion. In addition, we reserve the right to alter, edit, refuse to post or remove any postings or content, in whole or in part, for any reason and to disclose such materials and the circumstances surrounding their transmission to any third party in order to satisfy any applicable law, regulation, legal process or governmental request and to protect ourselves, our clients, sponsors, users and visitors.
Registration
To access certain features of the Site, we may ask you to provide certain demographic information including your gender, year of birth, zip code and country. In addition, if you elect to sign-up for a particular feature of the Site, such as chat rooms, web logs, or bulletin boards, you may also be asked to register with us on the form provided and such registration may require you to provide personally identifiable information such as your name and email address. You agree to provide true, accurate, current and complete information about yourself as prompted by the Site’s registration form. If we have reasonable grounds to suspect that such information is untrue, inaccurate, or incomplete, we have the right to suspend or terminate your account and refuse any and all current or future use of the Site (or any portion thereof). Our use of any personally identifiable information you provide to us as part of the registration process is governed by the terms of our Privacy Policy.
Passwords
To use certain features of the Site, you will need a username and password, which you will receive through the Site’s registration process. You are responsible for maintaining the confidentiality of the password and account, and are responsible for all activities (whether by you or by others) that occur under your password or account. You agree to notify us immediately of any unauthorized use of your password or account or any other breach of security, and to ensure that you exit from your account at the end of each session. We cannot and will not be liable for any loss or damage arising from your failure to protect your password or account information.
Limitation of Liability
UNDER NO CIRCUMSTANCES, INCLUDING, BUT NOT LIMITED TO, NEGLIGENCE, SHALL WE, OUR SUBSIDIARY AND PARENT COMPANIES OR AFFILIATES BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL OR CONSEQUENTIAL DAMAGES THAT RESULT FROM THE USE OF, OR THE INABILITY TO USE, THE SITE, INCLUDING OUR MESSAGING, BLOGS, COMMENTS OF OTHERS, BOOKS, EMAILS, PRODUCTS, OR SERVICES, OR THIRD-PARTY MATERIALS, PRODUCTS, OR SERVICES MADE AVAILABLE THROUGH THE SITE OR BY US IN ANY WAY, EVEN IF WE ARE ADVISED BEFOREHAND OF THE POSSIBILITY OF SUCH DAMAGES. (BECAUSE SOME STATES DO NOT ALLOW THE EXCLUSION OR LIMITATION OF CERTAIN CATEGORIES OF DAMAGES, THE ABOVE LIMITATION MAY NOT APPLY TO YOU. IN SUCH STATES, OUR LIABILITY AND THE LIABILITY OF OUR SUBSIDIARY AND PARENT COMPANIES OR AFFILIATES IS LIMITED TO THE FULLEST EXTENT PERMITTED BY SUCH STATE LAW.) YOU SPECIFICALLY ACKNOWLEDGE AND AGREE THAT WE ARE NOT LIABLE FOR ANY DEFAMATORY, OFFENSIVE OR ILLEGAL CONDUCT OF ANY USER. IF YOU ARE DISSATISFIED WITH THE SITE, ANY MATERIALS, PRODUCTS, OR SERVICES ON THE SITE, OR WITH ANY OF THE SITE’S TERMS AND CONDITIONS, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE USING THE SITE AND THE PRODUCTS, SERVICES AND/OR MATERIALS.
THIS SITE IS CONTINUALLY UNDER DEVELOPMENT AND COMPANY MAKES NO WARRANTY OF ANY KIND, IMPLIED OR EXPRESS, AS TO ITS ACCURACY, COMPLETENESS OR APPROPRIATENESS FOR ANY PURPOSE.
WITH REGARDS TO CONTENT RELATING TO HEALTH & WELLNESS ON THE SITE:
THIS SITE OFFERS HEALTH, WELLNESS, FITNESS AND NUTRITIONAL INFORMATION AND IS DESIGNED FOR EDUCATIONAL PURPOSES ONLY. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. IF YOU HAVE ANY CONCERNS OR QUESTIONS ABOUT YOUR HEALTH, YOU SHOULD ALWAYS CONSULT WITH A PHYSICIAN OR OTHER HEALTH-CARE PROFESSIONAL. DO NOT DISREGARD, AVOID OR DELAY OBTAINING MEDICAL OR HEALTH RELATED ADVICE FROM YOUR HEALTH-CARE PROFESSIONAL BECAUSE OF SOMETHING YOU MAY HAVE READ ON THIS SITE. THE USE OF ANY INFORMATION PROVIDED ON THIS SITE IS SOLELY AT YOUR OWN RISK.
NOTHING STATED OR POSTED ON THIS SITE OR AVAILABLE THROUGH ANY SERVICES ARE INTENDED TO BE, AND MUST NOT BE TAKEN TO BE, THE PRACTICE OF MEDICAL OR COUNSELING CARE. FOR PURPOSES OF THIS AGREEMENT, THE PRACTICE OF MEDICINE AND COUNSELING INCLUDES, WITHOUT LIMITATION, PSYCHIATRY, PSYCHOLOGY, PSYCHOTHERAPY, OR PROVIDING HEALTH CARE TREATMENT, INSTRUCTIONS, DIAGNOSIS, PROGNOSIS OR ADVICE.
Termination
We may cancel or terminate your right to use the Site or any part of the Site at any time without notice. In the event of cancellation or termination, you are no longer authorized to access the part of the Site affected by such cancellation or termination. The restrictions imposed on you with respect to material downloaded from the Site, and the disclaimers and limitations of liabilities set forth in these Terms of Service, shall survive.
Refund Policy
Your purchase of a product or service or ticket to an event may or may not provide for any refund. Each specific product, service, event or course will specify its own refund policy.
Digital Millennium Copyright Act
The Digital Millennium Copyright Act of 1998 (the “DMCA”) provides recourse for copyright owners who believe that material appearing on the Internet infringes their rights under the U.S. copyright law. If you believe in good faith that materials hosted by COMPANY infringe your copyright, you, or your agent may send to COMPANY a notice requesting that the material be removed or access to it be blocked. Any notification by a copyright owner or a person authorized to act on its behalf that fails to comply with requirements of the DMCA shall not be considered sufficient notice and shall not be deemed to confer upon COMPANY actual knowledge of facts or circumstances from which infringing material or acts are evident. If you believe in good faith that a notice of copyright infringement has been wrongly filed against you, the DMCA permits you to send to COMPANY a counter-notice. All notices and counter notices must meet the then current statutory requirements imposed by the DMCA; see http://www.loc.gov/copyright for details. COMPANY’s Copyright Agent for notice shall be annettegiarde@pro.bigboldhealth.com.
Assignment
This Agreement shall be binding upon and inure to the benefit of COMPANY and our respective assigns, successors, heirs, and legal representatives. Neither this Agreement nor any rights hereunder may be assigned without the prior written consent of COMPANY Notwithstanding the foregoing, all rights and obligations under this Agreement may be freely assigned by COMPANY to any affiliated entity or any of its wholly owned subsidiaries.
Dispute Resolution
These Terms of Use shall be governed by and construed in accordance with the laws of the State of Washington and any dispute shall be subject to binding arbitration in Bainbridge Island, Washington. If any provision of this agreement shall be unlawful, void or for any reason unenforceable, then that provision shall be deemed severable from this agreement and shall not affect the validity and enforceability of any remaining provisions.
Class Action Waiver
You may only resolve disputes with us on an individual basis, and may not bring a claim as a plaintiff or a class member in a class, consolidated, or representative action. Class arbitrations, class actions, private attorney general actions, and consolidation with other arbitrations aren’t allowed.
The arbitrator may not consolidate more than one person’s claims, and may not otherwise preside over any form of a class or representative proceeding or claims (such as a class action, consolidated action or private attorney general action) unless all relevant parties specifically agree to do so following initiation of the arbitration.
Severability
If any clause within these Terms of Service (other than the Class Action Waiver clause above) is found to be illegal or unenforceable, that clause will be severed from these Terms of Service, and the remainder of these Terms of Service will be given full force and effect. If the Class Action Waiver clause is found to be illegal or unenforceable, this entire Provision will be unenforceable and the dispute will be decided by a court.
Effective Date: March 2019
The following Privacy Policy governs the online information collection practices of BIG BOLD HEALTH LLC (“COMPANY,” “we” or “us”). Specifically, it outlines the types of information that we gather about you while you are using the www.bigboldhealth.com website (the “Site”), and the ways in which we use this information. This Privacy Policy, including our children’s privacy statement, does not apply to any information you may provide to us or that we may collect offline and/or through other means (for example, at a live event, via telephone, or through the mail).
Please read this Privacy Policy carefully. By visiting and using the Site, you agree that your use of our Site, and any dispute over privacy, is governed by this Privacy Policy. Because the Web is an evolving medium, we may need to change our Privacy Policy at some point in the future, in which case we’ll post the changes to this Privacy Policy on this website and update the Effective Date of the policy to reflect the date of the changes. By continuing to use the Site after we post any such changes, you accept the Privacy Policy as modified.
How We Collect and Use Information
We may collect and store personal or other information that you voluntarily supply to us online while using the Site (e.g., while on the Site or in responding via email to a feature provided on the Site). The Site only contacts individuals who specifically request that we do so or in the event that they have signed up to receive our messaging, attended one of our events, or have purchased one of our products. The Site collects personally identifying information from our users during online registration and online purchasing. Generally, this information includes name and e-mail address for registration or opt-in purposes and name, postal address, and credit card information when registering for our events or purchasing our products. All of this information is provided to us by you.
We also collect and store information that is generated automatically as you navigate online through the Site. For example, we may collect information about your computer’s connection to the Internet, which allows us, among other things, to improve the delivery of our web pages to you and to measure traffic on the Site. We also may use a standard feature found in browser software called a “cookie” to enhance your experience with the Site. Cookies are small files that your web browser places on your hard drive for record-keeping purposes. By showing how and when visitors use the Site, cookies help us deliver advertisements, identify how many unique users visit us, and track user trends and patterns. They also prevent you from having to re-enter your preferences on certain areas of the Site where you may have entered preference information before. The Site also may use web beacons (single-pixel graphic files also known as “transparent GIFs”) to access cookies and to count users who visit the Site or open HTML-formatted email messages.
We use the information we collect from you while you are using the Site in a variety of ways, including using the information to customize features; advertising that appear on the Site; and, making other offers available to you via email, direct mail or otherwise. We also may provide your information to third parties, such as service providers, contractors and third-party publishers and advertisers for a variety of purposes. Unless you inform us in accordance with the process described below, we reserve the right to use, and to disclose to third parties, all of the information collected from and about you while you are using the Site in any way and for any purpose, such as to enable us or a third party to provide you with information about products and services. If you do not wish your information to be used for these purposes, you must send a letter to the Online Privacy Coordinator whose address is listed at the end of this Privacy Policy requesting to be taken off any lists of information that may be used for these purposes or that may be given or sold to third-parties.
Please keep in mind that whenever you voluntarily make your personal information available for viewing by third parties online – for example on message boards, web logs, through email, or in chat areas – that information can be seen, collected and used by others besides us. We cannot be responsible for any unauthorized third-party use of such information.
Some of our third-party advertisers and ad servers that place and present advertising on the Site also may collect information from you via cookies, web beacons or similar technologies. These third-party advertisers and ad servers may use the information they collect to help present their advertisements, to help measure and research the advertisements’ effectiveness, or for other purposes. The use and collection of your information by these third-party advertisers and ad servers is governed by the relevant third-party’s privacy policy and is not covered by our Privacy Policy. Indeed, the privacy policies of these third-party advertisers and ad servers may be different from ours. If you have any concerns about a third party’s use of cookies or web beacons or use of your information, you should visit that party’s website and review its privacy policy.
The Site also includes links to other websites and provides access to products and services offered by third parties, whose privacy policies we do not control. When you access another website or purchase third-party products or services through the Site, use of any information you provide is governed by the privacy policy of the operator of the site you are visiting or the provider of such products or services.
We may also make some content, products and services available through our Site or by emailing messages to you through cooperative relationships with third-party providers, where the brands of our provider partner appear on the Site in connection with such content, products and/or services. We may share with our provider partner any information you provide, or that is collected, in the course of visiting any pages that are made available in cooperation with our provider partner. In some cases, the provider partner may collect information from you directly, in which cases the privacy policy of our provider partner may apply to the provider partner’s use of your information. The privacy policy of our provider partners may differ from ours. If you have any questions regarding the privacy policy of one of our provider partners, you should contact the provider partner directly for more information.
Be aware that we may occasionally release information about our visitors when release is appropriate to comply with law or to protect the rights, property or safety of users of the Site or the public.
Please also note that as our business grows, we may buy or sell various assets. In the unlikely event that we sell some or all of our assets, or one or more of our websites is acquired by another company, information about our users may be among the transferred assets.
Google Analytics
We also use Google Analytics Advertiser Features to optimize our business. Advertiser features include:
By enabling these Google Analytics Display features, we are required to notify our visitors by disclosing the use of these features and that we and third-party vendors use first-party cookies (such as the Google Analytics cookie) or other first-party identifiers, and third-party cookies (such as the DoubleClick cookie) or other third-party identifiers together to gather data about your activities on our Site. Among other uses, this allows us to contact you if you begin to fill out our check-out form but abandon it before completion with an email reminding you to complete your order. The “Remarketing” feature allows us to reach people who previously visited our Site, and match the right audience with the right advertising message.
You can opt out of Google’s use of cookies by visiting Google’s ad settings and/or you may opt out of a third-party vendor’s use of cookies by visiting the Network Advertising Initiative opt-out page.
As advertisers on Facebook and through our Facebook page, we, (not Facebook) may collect content or information from a Facebook user and such information may be used in the same manner specified in this Privacy Policy. You consent to our collection of such information.
We abide by Facebook’s Data Use Restrictions.
General Data Privacy Regulation (GDPR)
The GDPR took effect on May 25, 2018, and is intended to protect the data of European Union (EU) citizens.
As a company that markets its site, content, products and/or services online we do not specifically target our marketing to the EU or conduct business in or to the EU in any meaningful way. If the data that you provide to us in the course of your use of our site, content, products and/or services is governed by GDPR, we will abide by the relevant portions of the Regulation.
If you are a resident of the European Economic Area (EEA), or are accessing this site from within the EEA, you may have the right to request: access to, correction of, deletion of; portability of; and restriction or objection to processing, of your personal data, from us. This includes the “right to be forgotten.”
To make any of these requests, please contact our GDPR contact at annettegiarde@pro.bigboldhealth.com
Children’s Privacy Statement
This children’s privacy statement explains our practices with respect to the online collection and use of personal information from children under the age of thirteen, and provides important information regarding their rights under federal law with respect to such information.
The HIPAA Privacy Rule
The US Department of Health and Human Services provides: “The HIPAA Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically. The Rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. The Rule also gives patients rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections.”
You acknowledge that our operation of the Site does not constitute the practice of medicine, and specifically does not create a doctor-patient relationship between you and Dr. Jeffrey Bland, PhD (the “Doctor”). The information provided on the Site is for educational purposes only.
Notwithstanding the fact that the Site does not create a doctor-patient relationship between you and DOCTOR, our preservation of your personal health information shall be HIPAA compliant.
For purposes of this Privacy Policy, “patients” are those individuals who have secured the in-person services DOCTOR. If you are a patient of DOCTOR, you will be provided with a copy of DOCTOR’s HIPAA Privacy Statement, which governs the information collection practices of patients’ personal information by DOCTOR.
How do we store your information?
Your information is stored at the list server that delivers the Site content and messaging. Your information can only be accessed by those who help manage those lists in order to deliver e-mail to those who would like to receive the Site material.
All of the messaging or emails that are sent to you by the Site include an unsubscribe link in them. You can remove yourself at any time from our mailing list by clicking on the unsubscribe link that can be found in every communicaiton that we send you.
Changes to this Policy
This policy may be changed at any time at our discretion. If we should update this policy, we will post the updates to this page on our Website.
Questions About this Policy
If you have any questions or concerns regarding our privacy policy please direct them to: