Tag Archive for: lifestyle

Improving Your Body’s Infrastructure

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We need to plant our trees before we want the shade and fix our systems before they break.

I read that quote from Seth Godin in his daily blog last week, and it spoke to me. I immediately emailed him and explained it embodied what I want to teach you, my readers, on how to approach health; I wanted to use it giving him the attribution. He said no need and good luck.

My goal is to focus on lifestyle changes to make us the best version of ourselves. It’s much easier to prevent disease than treat it. It’s critical to make all our bodily systems as strong as they can be to prevent them from breaking down. It’s amazing that we will change the oil and filter in our car and replace furnace filters to make sure our car and home systems work well, but we don’t think of the food we eat as critical to making sure every system in our body works correctly and we don’t prioritize our annual check-ups.

What systems of yours need repair, tune-up, or preventive maintenance? I’ve given a lot of thought on that for my body, and I’ll share those thoughts with you Saturday. Feel free to share yours with me by replying to this memo; maybe you’ve thought of something I haven’t. It’s time to get our body’s infrastructure prepared for the health challenges we most assuredly will face.

What are you prepared to do today?

        Dr. Chet

What Should I Do?

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At this point, it seems that writing about anything other than COVID-19 is doing you, the reader, a disservice. But it also seems wrong to continue to talk about the topic you can’t escape hearing, talking, and thinking about, so I’m going to head back to reviewing research and health headlines next week.

For today, I’ve got some ideas about what you should be doing right now. We’re facing a new reality every time we step out our door. In fact, we may not be going out the door. It’s time to take control of those things we can control. But first, a slightly different view of what the next six months could be like.

A Solution Will Be Found

As you read this, someone is testing a new way of trying to treat the people who’ve acquired the COVID-19 virus. Someone else is trying to develop a faster way to test for the virus. For sure, there are many people working on a vaccine for the virus. That’s a logical order when you think about it. We need to be able to treat the people who have the disease now. Slow it down. Find a way to help the lungs resist the bacteria. It may be a drug approved for another purpose or it may be something brand new. That’s what we hope happens first. It will happen. We just want it to be sooner.

The ability to test for the virus quickly will be developed. When I say quickly, I mean a test that can be done to get the results in ten, five, or even two minutes, without using exotic metals or difficult-to-produce chemicals. One that can be performed at schools, restaurants, and especially at places of business. You get tested once in the morning in a drive-through center that takes a swab and get notified by cell phone with a code that says you’re virus free for that moment. It won’t be perfect, but it will bring back some semblance of normalcy. A new normalcy. At least for awhile.

Would a business want to develop that test? With mass production, it could drive the costs down. Would a place of business invest in that to protect workers? Or maybe the new reality will see some of the things we take for granted go away. Maybe more people will work remotely. As a teacher, I want to see your eyes to see whether you’re getting it or not, but maybe that won’t happen every time.

The vaccine will be made. Maybe it will finally force those who oppose vaccinations to take a hard look at why vaccinations should be a part of our lives. We’ll leave that fight for another day, and it’s one that will be waged.

A solution will be found for each area.

But What Should I Do Today?

As the virus moves on, we’re being asked to avoid human contact, which is really the only way to stop the spread of the virus. We should be hunkering down, if we are non-essential personnel, in our homes. I guess the next question is what do we do with all of this time?

Start tracking your temperature every day. Just as I recommend for blood pressure, start taking the temperature of everyone in the house every morning to establish a baseline. When it starts to deviate, check it more often. This is one of the key signs of the virus, so track your temperature every day.

Disinfect the main touchable surfaces in your home as often as reasonable but especially after you or another family member get home from a visit outside the home. I was fortunate—I had a quart of isopropyl alcohol. I saturate a paper towel and I wipe every door handle, the refrigerator handle, light switches, faucets, and finally the flushing handle in every bathroom. It takes about five minutes because you can let it air dry.

We’re all relying even more on electronics, so clean the surfaces you touch all the time: your phone, keyboard, mice, tablet, and remotes. (Follow special instructions for cleaning your screens.)

Finally, start working on really boosting your immune system. Get more sleep. Eat more vegetables and fruit. Start walking more every day; you can find exercise ideas on drchet.com and many other websites, and even DIY exercise equipment. Your immune system isn’t determined by taking a few supplements, although they can help; it’s determined by the lifestyle you live. Your normal routine is gone anyway, so start changing your lifestyle now.

The Bottom Line

Life as we’ve been living it has changed, and we will end up in a new normal. Take the time you have now and get your body prepared for it. That’s what you should be doing right now. Your body. Your choice.

What are you prepared to do today?

        Dr. Chet

Something Greater than Yourself

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Who’s going to analyze all of this data when data collection is complete? A better question might be who couldn’t analyze this data. The answer: anyone who has a good research question and agrees to abide by the guidelines of data usage can run an analysis. That could even be you. That’s correct; if you have a question and the ability to analyze the data, you could do it.

The goal is personalized medicine, and not just a pitch by a practice that’s talking about typical healthcare. The goal is to be able to identify the subgroups that will respond best to preventive health practices or to specific disease treatments. In that way, a profile of the best techniques based on genetics, environment, and lifestyle can be developed.

The only disappointment I have is that they didn’t include the microbiome. That would require a stool sample and add a greater degree of complexity to a data collection procedure that’s already very complicated. Maybe they’ll add that in the future.

If you go to the All of Us website, you’ll be able to find the local healthcare system in your area that’s responsible for data collection. In Grand Rapids, it’s Spectrum Health. I did the surveys online and scheduled an appointment for the physical data collection; that was it. In our area, we get a $25 gift card to a large grocery store chain, so I’m planning to get the whole family involved; Riley’s off the hook because you must be 18 and able to give consent. Whether you’re healthy or not doesn’t play a part in it; in fact, the info from people with current health conditions may be even more important.

The Bottom Line

The opportunity to become a part of something significant doesn’t happen all the time and almost never in preventive healthcare. This is time to do something greater than yourself, I can’t tell you whether it will benefit you personally, but it will benefit humanity. Maybe, just maybe, it will benefit a friend or relative. Check it out and check in to All of Us.

What are you prepared to do today?

        Dr. Chet

Reference: https://allofus.nih.gov/

All of Us: The Details

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Before I go further, I want you to consider this. For every variable, there will be a million data points. Height: one million. Weight: one million. Hip circumference: one million. You get the idea—and this is the simple stuff. The blood work alone could have 100 variables. Then we get into the DNA. Every gene has to be mapped to examine specific areas of DNA to see similarities or differences between healthy people and those with diseases.

If you volunteer, you will be called a partner instead of a subject. You’ll be giving the study plenty of information, but the information doesn’t just go one way. In the future, when there’s something that can benefit your health, you may be given information critical to preventing or treating a disease. The data collection includes giving Informed Consent and HIPAA for electronic data collection. Then there are several surveys and perhaps more in the future. There will also be blood and urine specimens as well as some baseline anthropomorphic data.

One thing that’s on everyone’s mind is information security. The researchers go into great detail to protect your identity. Data will be posted only with a number instead of a name, and the highest level of encryption available today will be used to protect your identity. I take security seriously, and I’m comfortable with it.

Check out the link in the Reference to find out more, and if you choose, to get started now yourself.

What are you prepared to do today?

        Dr. Chet

Reference: https://allofus.nih.gov/

All of Us

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Would you like to be part of one of the largest studies ever attempted in the U.S.? I decided I would and I think you should as well.

The study is called All of Us, and it’s an attempt to gather health data from one million or more volunteers and then track them over many years. The purpose is to examine how genetics, environment, and lifestyle can impact health and disease. The goal is to provide a database that researchers can use to determine the factors that can impact the development of disease and eventually, the most effective treatment.

I think that’s the real goal. We have no idea what causes many diseases, whether it’s arthritis, cancer, auto-immune, or many others. The same holds true for treatments. Why does one treatment work well on one person and not at all on another? The genetics and environment as well as lifestyle may all have a role; with a database so extensive, just about every type of human subgroup will be represented.

What’s involved? I’ll tell you that on Thursday. If you want to read about all the details involved, check out the link in the References.

What are you prepared to do today?

        Dr. Chet

Reference: https://allofus.nih.gov/

The Bottom Line on the 2018 Cholesterol Guidelines

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In Thursday’s Memo, I talked about the 2018 Cholesterol Guidelines and evidence-based medicine, focusing on the physician side of the treatment discussion. But I believe that’s not the most important part of the discussion; I think the critical part is the patient side. Here’s why.

The Cholesterol Guidelines focus on lifestyle changes first: a healthier diet, exercise, quitting smoking, and weight loss. That’s supposed to be the initial part of the potential treatment plan—lifestyle first. In other words, what will the patients do for themselves before the discussion leads to medications, especially statins?

The guidelines aggressively focus on the use of statins and other medications to get the LDL-cholesterol to desirable levels, so we have a dilemma during the discussion of a treatment plan. Do the physicians assume, based on experience, that the patients won’t do what they’re supposed to do to lower their risk of CVD and immediately prescribe medications? Or do the patients take the lifestyle route seriously and do what’s necessary to change their health?

To be blunt, we patients haven’t done our part. We lose weight and gain it back. We start to eat healthier and don’t sustain it. We start to exercise, but we let life get in the way and stop, or we push too hard and get injured and stop, or the weather turns colder or hotter and we stop. When we agree to change our health habits and then don’t follow through, we make our health issues worse—they’re still in there eating away at our lifespan and not being treated.

Don’t make promises you know you won’t keep; notice I didn’t say can’t keep, I said won’t keep. If you know in your heart you’ll never change your diet or keep up with exercise, the best thing you can do for your health is don’t delay: start taking the meds and start taking care of the problem.

Although I disagree with it, I get why physicians jump to meds. There’s only one way to change that: we have to prove them wrong when they assume we won’t stick to a healthier lifestyle.

The Bottom Line

The 2018 Cholesterol Guidelines put the responsibility for lowering the risk of CVD without medications in our hands—the patients. Work out a timeline with some concrete goals for each lifestyle area with your physician. It won’t be easy: regular exercise for life, eating better from now on, quitting smoking, plus getting to a normal weight and staying there will all take time and consistent effort. That’s okay because even if your risk of CVD is high, it doesn’t mean you drop dead tomorrow. Even if you fall into an at-risk scenario, I know you can do it. There are many tools to help you keep at it: an app, a workout buddy, a Facebook group, and more.

Instead of looking at your health challenge as an obstacle, look at it as an opportunity for better health. If you say you don’t want to take medications, this is your chance to prove whether you really mean it. I can’t guarantee you’ll never need the meds, but you can work your way down to a smaller dosage with fewer side effects.

It all depends on your answer to one question: what are you prepared to do today?

Dr. Chet

 

Reference: www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000625.

 

Genetics or Lifestyle?

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My dad died of a heart attack when he was 41. That fact has always been hanging over my head, especially when I had a heart blockage 16 years ago; the coronary artery was opened, I had a stent put in and have had no issues since. Was it my genes or was it lifestyle? Genotype or genes versus phenotype or lifestyle. I’ve always said genes, but not any more.

Researchers recently published an analysis of over 800 million individuals after examining births, deaths, and relationships between the individuals: in other words, who married whom, how many children they had, how long they lived. They found that a role for a genetic component of longevity was supported in family trees of people who were related. But here’s the interesting thing: they also found that there was a longevity relationship between non-blood relatives as well. In other words, the subjects’ in-laws shared similar traits for longevity.

What does that mean? Perhaps people unconsciously select mates with comparable traits. Because we don’t do that intentionally by genetics, it means that similar environments have a similar impact.

The actual role of genetics was estimated to be well below 10%. In other words, phenotype or lifestyle is more meaningful than your genes for how long you live. This was a very complicated mathematical analysis, so we should proceed with caution, but there’s little question that lifestyle has more to do with longevity than your genes.

Good genes give you a good start, but what you do after that matters most. What should you do? Eat better. Eat less. Move more.

Your body. Your choice. What are you prepared to do today?

Dr. Chet

 

Reference: https://doi.org/10.1534/genetics.118.301613

 

Life Expectancy Is More Than Living Longer

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What’s more important to you: living longer or living better with the years you have? Think about it as you read this Memo and I’ll come back to that later.

The Upside of the Study

There were three important lifestyle variables that clearly stood out (1). The more exercise you get, the better off you are. Of those who got perfect 5s, they averaged over an hour per day of exercise. Second, the lower the BMI, the better; researchers didn’t track who might have lost weight over the years to get in the lowest BMI category, but it’s clear that carrying fewer pounds helps.

Finally, the Alternate Healthy Eating Index (AHEI) is a score of the quality of the diet, not the quantity. The highest quintile was below 60 out of 100 possible points. That means you don’t have to eat perfectly; just eat your vegetables and fruit and fewer refined carbohydrates and sugars, and you’ll see benefits.

The Downside of the Study

The subjects were overwhelmingly white and they were nurses and doctors for the most part. Whether that translates to other races and professions, we just don’t know.

The biggest issue for me is the Food Frequency Questionnaire used in the original studies as well as the AHEI scores. Trying to remember what you’ve eaten in so many categories over a year never made sense to me; there’s just too much potential for error. There were also differences in AHEI scores between the Nurses Study (all women) and the Health Professionals Follow-Up Study (all men). The men had an AHEI of 59 while the women in the nurses study had an AHEI of 37.5 in the groups assigned a 5. That makes no sense to me. I know the FFQ were slightly different, but the way the data are extracted to arrive at the AHEI score should have accounted for that. Are men so much better with the quality of their diet? Not buying it.

Supplements

Here’s something I found interesting. The use of a baby aspirin went up as the overall scores went up. In contrast, multivitamin use went up as the overall scores went down. To me, that means that healthcare professionals in all professions know that taking a baby aspirin is good for you. It also means that the poorer the diet, the more people try to compensate with supplements. The goal should be to complement a good diet with a multi, not try to make up for a poor one.

Amount of Time Living with Disease

I asked you a question at the beginning of this memo: what’s more important to you: living longer or living better? Right now, the average number of years spent living with some form of disease is almost 12 years (2). Not every condition is as debilitating as others, but would you rather live longer no matter what your health is or would you rather live well right up to the day you check out? Only you can answer that one. The study didn’t examine quality of life so we don’t know how the subjects did.

Here’s my guess: I would wager that the more healthy lifestyle variables you can add to your life, the longer and better you will live. Eat less. Eat better. Move more. It all starts with those six words.

What are you prepared to do today?

Dr. Chet

 

References:
1. https://doi.org/10.1161/CIRCULATIONAHA.117.032047.
2. https://ourworldindata.org/life-expectancy.

 

How Much Does a Healthier Life Increase Life Expectancy?

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This week is about life expectancy and the results of a recent study on how to possibly extend it. Looking at lifestyle’s impact on mortality, here are the criteria researchers applied (1).

  • Smoking: never smoked
  • BMI: 18.5–24.9
  • Exercise: at least 30 minutes daily of moderate to vigorous physical activity which included brisk walking
  • Healthy diet: high diet quality score (upper 40%) of the Alternate Healthy Eating Index
  • Moderate daily alcohol intake: one drink or less for women, two or less for men

Individuals were given one point for each factor if they complied, 0 if they did not, so every person had a score between 0 and 5. The researchers then calculated predicted life expectancy for each score.

Here’s what they determined. Comparing those who had perfect 5s on their lifestyle score with those who had 0, women who were 50 years old were projected to live an average of 43 more years while men were projected to live another 37 years. For the subjects who scored 0 on the lifestyle score, the women were projected to live another 29 years while the men had another 25.5 years. That’s an additional 14 and 12 years respectively.

This was not all in or all out; the higher the lifestyle score, the longer someone was projected to live. I think it’s important to know that you don’t have to do it all at once. No matter what your current age, one significant change may help you live longer.

On Saturday I’ll wrap up this look at lifestyle and life expectancy.

What are you prepared to do today?

Dr. Chet

 

Reference: https://doi.org/10.1161/CIRCULATIONAHA.117.032047.

 

U.S. Life Expectancy Is Down—Again

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Life expectancy is the average time a person might live; a baby born in 2017 will be expected to live 78.6 years according to the U.S. Centers for Disease Control. That’s a long time, but it could be better. After reaching a high in 2015, U.S. life expectancy decreased in 2017 (1). It was only a tenth of a year, just over a month, but it’s the second year in a row life expectancy in the U.S. decreased.

Where do other major countries stand on life expectancy? Japan still leads the world at 85 years (2). Other notable countries are Australia and Italy at 82.3 and Sweden at 82.1. Our neighbors to the north in Canada are at 81.9 years, tied with France and Norway. The lowest quartile is mostly African countries; click the second reference below to find where other countries rank. Where does the U.S. rank? In the mid-40s. Seems like we should be higher, doesn’t it?

Researchers decided to examine how lifestyle could impact life expectancy. They used data from the Nurses Health Study and the Health Professionals Follow-up Study with a combined subject pool of over 120,000 men and women who’ve been followed since the 1980s. They then calculated a health score for each subject, examined who died and what they died from over the past 30 or so years, and examined how health habits related to mortality. We’ll check out the results in Thursday’s Memo.

What are you prepared to do today?

Dr. Chet

 

References:
1. https://www.cdc.gov/nchs/data/databriefs/db293.pdf.
2. http://bit.ly/2sl8TcH
3. https://doi.org/10.1161/CIRCULATIONAHA.117.032047.