Meet a passionate proponent of integrative health and wellness
By Julie Kemble Borths
Sian Cotton never thought she would come back home to Cincinnati.
She had gone East for college, then West for graduate school, earning a Ph.D. in psychology. She developed a particular interest in the impact the mind can have on physical health, reinforced by her research. This approach, known as integrative health, became more than something to study.
“Integrative health became my passion,” Cotton said.
As she continued her journey in her hometown, she found pockets of research and treatment related to the mind-body connection, but no community for practitioners to learn from each other or to work together to educate the community.
Now the director of the University of Cincinnati Center for Integrative Health and Wellness, she remembered when she told one local researcher there were centers all over the country which were improving people’s health, and asked “Why are we not doing this?” He simply said, “You’re right. Why don’t you lead it?’”
In 2013 she began leading a team at UC Health which includes 27 affiliated UC faculty members across 12 departments. They advise patients about comprehensive ways to improve their health through better nutrition, exercise and reduced stress. They work in areas as diverse as oncology and cardiology, but all look to integrate basic wellness practices into the Cincinnati healthcare environment.
The daughter of a surgeon and a family practice physician in Hyde Park, Cotton started out pursuing a music degree. Her voice lessons led to breath work. Her breath work led to yoga. Finding she had more of a passion for her psychology classes than for the others, she was drawn to bring the healing properties of yoga and music to her future patients.
Her interests coincided with a growth in research of what was, at the time, called alternative or complementary practices, and she found opportunities in working with troubled children and women with breast cancer.
Along the way, she learned more about the role of nutrition in overall health and gradually became a vegetarian. In her family, each member “chooses their own path,” but as her children gather around the kitchen counter to cook, she helps them to be mindful of their choices. “It’s such a joy to see them develop their own thoughts on things,” she said. “And they will actually ask to pick out what we are having for dinner. It’s fun for them to try to get as much color as possible on a plate.”
Cotton recently returned from an energizing trip to “Healthy Kitchens, Healthy Lives,” a joint project in Napa Valley, California, between the Culinary Institute of America and the Harvard T.H. Chan School of Public Health. “It combines the best of culinary innovation and nutritional science,” she said. “It’s what you do with the turmeric and what the data is on turmeric.”
UC Health is developing a similar project at Indian Hill’s entirely organic Turner Farm. At the kitchen, housed in a renovated barn, a menu of educational programs includes healthy cooking, mindful eating, movement and self-care.
“We get people in there, and then we teach them,” she said. While the classes for adults, children and families excite her, she sees the most potential in how UC medical students participate. “They are always being taught to fix people when they are broken,” she said. “But at the learning kitchen, and in integrative medicine, they can focus on prevention. They can get armed with the knowledge of how nutrition, movement and stress reduction can often do more than just handing a patient a prescription.”
Cotton said these physicians in training welcome the information. “They know that they can’t learn everything. But they know that they need to have nutrition literacy, to know more about mindfulness, if they are going to help their patients.”
It’s difficult, Cotton said, for doctors as well as patients, to sort through all the health-related news on a daily basis. “There is so much misinformation,” she said. “That’s why we really look for what is evidence-based,” which means scientific data show the effectiveness of a therapy or approach.
One example of integrative medicine at work is in the life of her colleague, Dr. John M. Tew. At 81, he has seen a lot of change. As a neurosurgeon and laser pioneer, he always had new techniques to learn, different ways to improve his patients’ health.
But 20 years ago he saw the greatest change – and it was in his own health.
“I got severe gout, and I had thought I was conscious of my exercise and diet,” he said. “I realized I was not as conscientious as I needed to be.”
He became a vegetarian, began to meditate and altered his exercise routine to include yoga and Pilates. He no longer needs medication for gout.
“I’m living a long and vital life,” Tew said. “We are learning the pathways that prevent chronic disease while including preventative measures like antibiotics and immunizations.”
And, as in his case, he sees ways chronic disease is not only prevented, but reversed.
That’s why he continues his involvement at UC Health Integrative Medicine as both a neurosurgery professor and as executive director of community affairs. And it’s why he applauds Cotton’s leadership.
“She is extraordinary. She is iconic in her interest in change, research, and in new ways to promote wellness and health,” Tew said.
Cotton’s efforts in leading the program are part of a much larger picture, he said. Across the country, through a formal consortium of medical schools, physicians are exchanging information and patients’ health is improving.
“This change, which is occurring throughout medicine, is happening one person, one community at a time,” Tew said. “It applies to the kinds of health issues that everyone is talking about – diabetes, obesity, heart disease, cancer. But it also applies to mental illness and other serious disease.”
By bringing together the medical school, outreach and research efforts, as well as clinical care, Tew said UC Health has an opportunity to significantly change the health of the community. He said Cotton’s leadership makes that possible.
One of the center’s supporters, Buck Niehoff of Hyde Park, became a vegetarian so long ago he claims he’s never had a McDonald’s hamburger. “They hadn’t been invented yet,” he joked. Back then, it was lonely to be so passionate about such health choices, so Niehoff is thrilled UC Health has become so invested in integrative medicine.
“It is a relationship of colleagues or partners to learn more about how to have a healthy lifestyle,” he said. “The more elements you add on to your lifestyle,” like meditation, yoga or different kinds of exercise, “the better you feel.”
As a retired attorney, Niehoff is research-oriented and appreciates the evidence-based information he can access through the center. For instance, at 70 he recently learned more about meditation and is finding ways to be more mindful.
Carrie Hayden of Newport, who serves as interim chair of the center’s community advisory board, came to the center by way of illness. On her second encounter with cancer, the 59-year-old was determined not to suffer like she did with earlier chemotherapy. Thanks to acupuncture, therapeutic massage, mindfulness and other treatments she learned about, “I got through in halfway decent shape the last time,” she said.
Not only was she better able to deal with the pain and discomfort from her cancer treatment, she learned how to change her lifestyle to make it less likely she will face cancer again. “I literally changed the health status of my body. I went to a plant-based diet, use yoga and massage and really take care of myself,” she said.
“Your body is the driving mechanism for everything,” Hayden said. “You have to feed it the right fuel, get it moving, stretching. And when you reduce your stress, you get rid of the other things that can hurt your body and keep you from being smarter and faster and everything else.”
At her home, Cotton has the same attitude about incorporating self-care into her own life and the habits of her family. Her approach can seem remarkably casual with few cookbooks and the controlled chaos of a busy family surrounding her. “I’m a working mom of three,” she said. “I just cook stuff. We eat at home most of the time because people who cook at home more are healthier. If we would just do that more, we would do better healthwise.”
Beyond the kitchen, “I live and breathe mindfulness all the time,” she said. “And we teach our children that, too.”
“It’s a busy time in my life,” Cotton said. “So I make sure I sleep. My emails are never going to be all be done, but I know I need sleep. So I’m in bed every night around 9:30.”
Her exercise routine combines movement and mindfulness. She doesn’t talk on the phone or listen to lively music when she takes a walk or uses the treadmill each day. She concentrates on her breath, her movement, what’s around her. Every morning, she takes 5 to 10 minutes for yoga and every week goes to a class.
“I’ve studied the physiology of stress, what happens when our bodies go into ‘fight or flight,’” she said. “If you never come down from that, you cannot return to baseline. That hurts everything. Your memory. Your overall functioning.”
So Cotton has learned to put her phone away, to make time to go outside – even if it is just for a 7-minute walk – and to just be.
“Mindfulness is about being aware, being in the moment right now,” she said. “It’s nonjudgmental. It’s a time to reflect before we react.”
This kind of approach can help those suffering from depression as well as chronic physical illnesses like diabetes and heart disease. And scientists have found all kinds of applications for treating cancer and other acute diseases.
“It’s nothing fancy,” she said. “But if you go about things with intention, you can experience more.”
More about Sian Cotton
Husband Brian Riker, a clinical psychologist with a practice in Mount Lookout. They have three children: Sophia, 12; Jonah, 10; and Noah, 8
Her front porch in Mount Lookout, preferably with her entire family and Cooper, a Bernese mountain dog
A Good Evening Out:
Favorite Place She Doesn’t Get to Often:
“Sing,” with her two sons
It’s on all the time at the Cotton-Riker house. Mostly Windham Hill and Adele
Books on the Nightstand:
“Gratitude” by Oliver Sacks, “When Breath Becomes Air” by Paul Kalanithi and “The Rainbow Comes and Goes” by Anderson Cooper and Gloria Vanderbilt
A summer vacation to the beach at Hilton Head and a visit to Cotton’s grandmother’s homestead in Cornwall, England
Quotes that Inspire:
“Eat food, not too much, mostly plants.” – Michael Pollan
“If we are not fully ourselves, truly in the present moment, we miss everything.” – Thich Nhat Hanh
Understanding integrative medicine
Dr. Andrew Weil, a noted integrative medicine proponent, gives the following definition: Integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.
Information on UC Health’s providers and programs are at uchealth.com/integrative
John Tew suggests watching “Forks Over Knives,” available through forksoverknives.com